Provider Demographics
NPI:1598000648
Name:LAKEWOOD HATZOLAH, LLC
Entity Type:Organization
Organization Name:LAKEWOOD HATZOLAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZELDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-5600
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-363-5600
Mailing Address - Fax:732-363-5658
Practice Address - Street 1:501 COUNTY LINE ROAD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-363-5600
Practice Address - Fax:732-363-5658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1512014341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance