Provider Demographics
NPI:1821248907
Name:LACAY, EDMAR MANABAT (MD)
Entity Type:Individual
Prefix:DR
First Name:EDMAR
Middle Name:MANABAT
Last Name:LACAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 502
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-968-7433
Practice Address - Fax:856-968-8499
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2016-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125053230207Q00000X
NJ25MA08985600207QS0010X
PAMD443555207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine