NPIMap

Organization Active NPI

Medallion Services LLC

  • Developmentally Disabled Services Day Training Agency
  • Lakewood, NJ
National Provider Identifier
1811384977
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
MEDALLION SERVICES LLC
Practice address
212 2ND St
Suite 105
Lakewood, NJ 08701-3424
Phone
(732) 961-2020
Fax
(732) 961-1754
NPI assigned
Apr 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Michael Lutz
Title
Owner
Phone
(732) 961-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

212 2ND St
Suite 105
Lakewood, NJ 08701-3424

Mailing address

212 2ND St
Suite 105
Lakewood, NJ 08701-3424
Phone (732) 961-2020

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1811384977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 2ND ST",
            "address_2": "SUITE 105",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013424",
            "telephone_number": "732-961-2020",
            "fax_number": "732-961-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 2ND ST",
            "address_2": "SUITE 105",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013424",
            "telephone_number": "732-961-2020",
            "fax_number": "732-961-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDALLION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-961-2020"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.