Provider Demographics
NPI:1124024401
Name:LIM, NORMAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:L
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6 BALDWIN CT
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1331
Mailing Address - Country:US
Mailing Address - Phone:973-226-9182
Mailing Address - Fax:973-226-6265
Practice Address - Street 1:148 SOUTH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-2719
Practice Address - Country:US
Practice Address - Phone:973-465-8590
Practice Address - Fax:973-230-9710
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05353700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA05353700BNBOtherHEALTHFIRST NJ
NJ6029108Medicaid
NJ1125997OtherHORIZON NJ HEALTH NUMBER
NJ1K7960OtherHEALTHNET PROVIDER #
NJ01000339600OtherUNITED HEALTH CARE AMERICHOICE