Provider Demographics
NPI:1730369562
Name:CENTRAL JERSEY LUNG CENTER, P.A.
Entity type:Organization
Organization Name:CENTRAL JERSEY LUNG CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:FEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-658-5307
Mailing Address - Street 1:333 FORSGATE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1567
Mailing Address - Country:US
Mailing Address - Phone:732-658-5307
Mailing Address - Fax:732-453-1703
Practice Address - Street 1:333 FORSGATE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1567
Practice Address - Country:US
Practice Address - Phone:732-658-5307
Practice Address - Fax:732-453-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06205600207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty