Provider Demographics
NPI:1225153349
Name:LALITHA KRISHNAN, MD PC
Entity Type:Organization
Organization Name:LALITHA KRISHNAN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-895-9700
Mailing Address - Street 1:PO BOX 2105
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-2105
Mailing Address - Country:US
Mailing Address - Phone:732-905-0022
Mailing Address - Fax:732-818-4810
Practice Address - Street 1:14 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6402
Practice Address - Country:US
Practice Address - Phone:732-905-0022
Practice Address - Fax:732-818-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45853208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0662907Medicaid
NJ080466Medicare PIN