Provider Demographics
NPI:1437374147
Name:LEWIS J MUFSON MD PA
Entity Type:Organization
Organization Name:LEWIS J MUFSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MUFSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-780-1888
Mailing Address - Street 1:8 THOREAU DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4666
Mailing Address - Country:US
Mailing Address - Phone:732-780-1888
Mailing Address - Fax:732-780-0148
Practice Address - Street 1:8 THOREAU DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4666
Practice Address - Country:US
Practice Address - Phone:732-780-1888
Practice Address - Fax:732-780-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25689207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0870404Medicaid
NJC59578Medicare UPIN
NJMU179758Medicare ID - Type Unspecified