Provider Demographics
NPI:1437764859
Name:EDWARD LAUB MD LLC
Entity Type:Organization
Organization Name:EDWARD LAUB MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EUN KYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:HUH
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE ASSISTANCE
Authorized Official - Phone:609-586-8996
Mailing Address - Street 1:2053 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3413
Mailing Address - Country:US
Mailing Address - Phone:609-586-8996
Mailing Address - Fax:609-586-1579
Practice Address - Street 1:2053 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3413
Practice Address - Country:US
Practice Address - Phone:609-586-8996
Practice Address - Fax:609-586-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty