Provider Demographics
NPI:1801828330
Name:LAMBA, RENU (MD)
Entity type:Individual
Prefix:
First Name:RENU
Middle Name:
Last Name:LAMBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 FARLEY RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-5033
Mailing Address - Country:US
Mailing Address - Phone:201-285-5972
Mailing Address - Fax:
Practice Address - Street 1:473 BROADWAY
Practice Address - Street 2:SUITE 411
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3697
Practice Address - Country:US
Practice Address - Phone:201-285-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437854207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA164977Medicare PIN