Provider Demographics
NPI:1942518063
Name:JEFFREY F. LAKIN MD PA
Entity type:Organization
Organization Name:JEFFREY F. LAKIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:LAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-365-1139
Mailing Address - Street 1:642 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1615
Mailing Address - Country:US
Mailing Address - Phone:973-365-1139
Mailing Address - Fax:973-365-1664
Practice Address - Street 1:642 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1615
Practice Address - Country:US
Practice Address - Phone:973-365-1139
Practice Address - Fax:973-365-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty