Provider Demographics
NPI:1598022550
Name:JAY LOVENHEIM, DO, FAAP, PA
Entity Type:Organization
Organization Name:JAY LOVENHEIM, DO, FAAP, PA
Other - Org Name:LUBIN AND LOVENHEIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVENHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-325-1115
Mailing Address - Street 1:101 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1000
Mailing Address - Country:US
Mailing Address - Phone:973-325-1115
Mailing Address - Fax:973-325-1186
Practice Address - Street 1:101 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1000
Practice Address - Country:US
Practice Address - Phone:973-325-1115
Practice Address - Fax:973-325-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08056500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty