Provider Demographics
NPI:1467451757
Name:LUNDY, JAMES R JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:LUNDY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 90TH ST
Mailing Address - Street 2:APT. 10F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1100
Mailing Address - Country:US
Mailing Address - Phone:347-229-3727
Mailing Address - Fax:
Practice Address - Street 1:250 W 90TH ST
Practice Address - Street 2:APT. 10F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1100
Practice Address - Country:US
Practice Address - Phone:347-229-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1727207P00000X
VA0102201110207P00000X
NJ25MB07371800207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8791309Medicaid
NJ8791309Medicaid
NJ056645UXKMedicare PIN
NJ056645MK3Medicare PIN
NJ056645DLEMedicare PIN
NJ056645UWYMedicare PIN
NJ056645UWXMedicare PIN
NJ056645SNYMedicare PIN
H23679Medicare UPIN
NJ056645SN3Medicare PIN