Provider Demographics
NPI:1225111453
Name:HEALTHPOINT MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HEALTHPOINT MEDICAL GROUP, LLC
Other - Org Name:HEALTHPOINT MEDICAL GROUP OF OLD BRIDGE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:LALLEMAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:732-613-1000
Mailing Address - Street 1:158 W 27TH ST
Mailing Address - Street 2:11TH FLOOR SOUTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6216
Mailing Address - Country:US
Mailing Address - Phone:212-563-2497
Mailing Address - Fax:212-563-0605
Practice Address - Street 1:59 ROUTE 516 E
Practice Address - Street 2:
Practice Address - City:OLD
Practice Address - State:NJ
Practice Address - Zip Code:08857-1416
Practice Address - Country:US
Practice Address - Phone:732-613-1000
Practice Address - Fax:732-613-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082526S3LMedicare PIN
NY082554Medicare PIN