Provider Demographics
NPI:1407906282
Name:CASE, PHILIP LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:LAWRENCE
Last Name:CASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:80 SCENIC DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5211
Mailing Address - Country:US
Mailing Address - Phone:732-577-1242
Mailing Address - Fax:732-358-7250
Practice Address - Street 1:80 SCENIC DR STE 1
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5211
Practice Address - Country:US
Practice Address - Phone:732-577-1242
Practice Address - Fax:732-358-7250
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2023-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04236800207RA0201X, 2080P0201X, 207KA0200X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC31964Medicare UPIN