Provider Demographics
NPI:1336561570
Name:LIFEROCK MEDICAL LLC
Entity Type:Organization
Organization Name:LIFEROCK MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-803-1210
Mailing Address - Street 1:409 MINNISINK RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1846
Mailing Address - Country:US
Mailing Address - Phone:201-294-4791
Mailing Address - Fax:973-256-5034
Practice Address - Street 1:409 MINNISINK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1846
Practice Address - Country:US
Practice Address - Phone:201-294-4791
Practice Address - Fax:973-256-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1005633416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport