Kenneth J Lichtman MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA03137800 Issued in NJ

Legal business name

KENNETH J LICHTMAN MD LLC

Practice address

1109 Amboy Ave
Edison, NJ 08837-2877

Phone

(732) 549-2220

NPI assigned

Sep 26, 2017

Last updated

Sep 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Allaire

Title

Sec

Phone

(732) 549-2220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506384000000",
    "number": "1770092405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 AMBOY AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 AMBOY AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372877",
            "telephone_number": "732-549-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J LICHTMAN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A",
        "authorized_official_last_name": "ALLAIRE",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "SEC",
        "authorized_official_telephone_number": "732-549-2220"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03137800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.