Provider Demographics
NPI:1851615025
Name:LINDBERG, LAWRENCE RICHARD (RPH,, MBA)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:RICHARD
Last Name:LINDBERG
Suffix:
Gender:M
Credentials:RPH,, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CREST DR
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1226
Mailing Address - Country:US
Mailing Address - Phone:732-271-9792
Mailing Address - Fax:
Practice Address - Street 1:4041 HADLEY RD
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1111
Practice Address - Country:US
Practice Address - Phone:908-222-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01875700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist