Provider Demographics
NPI:1124174404
Name:EUGENE J. LIND, M.D.P.A.
Entity type:Organization
Organization Name:EUGENE J. LIND, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUIGENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-6420
Mailing Address - Street 1:1656 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2805
Mailing Address - Country:US
Mailing Address - Phone:732-494-6420
Mailing Address - Fax:732-494-5079
Practice Address - Street 1:1656 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2805
Practice Address - Country:US
Practice Address - Phone:732-494-6420
Practice Address - Fax:732-494-5079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2794900Medicaid
NJF13519OtherHEALTHNET
NJ4412711OtherAETNA
NJLS061OtherOXFORD
NJ2794900Medicaid
NJ4412711OtherAETNA