Lifestyles Medical

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MB07769000 Issued in NJ

Legal business name

LIFESTYLES MEDICAL

Practice address

107 Monmouth Rd
Suite 104 D
West Long Branch, NJ 07764-1021

Phone

(732) 542-2638

Fax

(732) 542-2620

NPI assigned

Jun 10, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Rand Salani

Title

Admin

Phone

(732) 542-2638

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1699188359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MONMOUTH RD",
            "address_2": "SUITE 104 D",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641021",
            "telephone_number": "732-542-2638",
            "fax_number": "732-542-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MONMOUTH RD",
            "address_2": "SUITE 104 D",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641021",
            "telephone_number": "732-542-2638",
            "fax_number": "732-542-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLES MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "SALANI",
        "authorized_official_first_name": "RAND",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "732-542-2638",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05539700",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MB07769000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE ID NUMBER",
            "identifier": "0600410687",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi G Lamie, PHARM D
• David Michael Laporta, D.P.M.
• John A Laurino, D.P.M.
• Patrick Lee, MD
• Lyubov Libman, DDS
• Ashley Lobbato, LCSW
• Dominick Anthony Lobraico, D.O.
• Jonathan Henry Lustgarten, M.D.
• Lymphedema Therapy Center of New Jersey
• M Ottaviano LLC

• General Practice Physician in West Long Branch, NJ
• Providers in West Long Branch, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.