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1417976341
JOHNNY LARSEN
LAKEWOOD, NJ
NPI
1417976341
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NJ 25MB05391100)
Enumeration Date
2006-07-19
Last Update Date
2007-07-08
Business Address
-- JOHNNY LARSEN DO
600 RIVER AVE KIMBALL MEDICAL CENTER
LAKEWOOD, NJ 08701-5237
Phone number: 732-363-1900
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Mailing Address
-- JOHNNY LARSEN DO
PO BOX 717
LIVINGSTON, NJ 07039-0717
Phone number: 973-740-0607
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