Provider Demographics
NPI:1710011341
Name:LABORATORY MEDICINE ASSOCIATES, PA
Entity type:Organization
Organization Name:LABORATORY MEDICINE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINTERHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-229-8711
Mailing Address - Street 1:279 3RD AVE
Mailing Address - Street 2:PO BOX 417
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6205
Mailing Address - Country:US
Mailing Address - Phone:732-229-8494
Mailing Address - Fax:732-229-0245
Practice Address - Street 1:279 3RD AVE STE 508
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6205
Practice Address - Country:US
Practice Address - Phone:732-229-8494
Practice Address - Fax:732-229-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207ZP0102X
NJ284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes284300000XHospitalsSpecial Hospital
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2855209Medicaid
NJ2855209Medicaid