Provider Demographics
NPI:1144406414
Name:LIFECARE PHYSICIANS, P.C
Entity Type:Organization
Organization Name:LIFECARE PHYSICIANS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-599-5095
Mailing Address - Street 1:500 GROVE STREET CREDENTIALING
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-323-1208
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:1225 WHITEHORSE MERCERVILLE RD.
Practice Address - Street 2:BUILDING D SUITE 203 LIFECARE PHYSICIANS OF HAMITTON
Practice Address - City:HAMITTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3882
Practice Address - Country:US
Practice Address - Phone:609-581-6060
Practice Address - Fax:609-581-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA39516207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty