Provider Demographics
NPI:1154950269
Name:MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Entity type:Organization
Organization Name:MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LASNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-608-2136
Mailing Address - Street 1:375 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1823
Mailing Address - Country:US
Mailing Address - Phone:201-894-3012
Mailing Address - Fax:
Practice Address - Street 1:142 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2547
Practice Address - Country:US
Practice Address - Phone:201-568-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty