Provider Demographics
NPI:1740451046
Name:LEWIS T LADOCSI MD LLC
Entity type:Organization
Organization Name:LEWIS T LADOCSI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-731-7707
Mailing Address - Street 1:776 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1102
Mailing Address - Country:US
Mailing Address - Phone:973-731-7707
Mailing Address - Fax:973-669-0277
Practice Address - Street 1:776 NORTHFIELD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1102
Practice Address - Country:US
Practice Address - Phone:973-731-7707
Practice Address - Fax:973-669-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02517700207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty