Individual provider Active NPI

David Lichtenstein, M.D.

  • Specialist
  • Woodbridge, NJ
National Provider Identifier
1942304969
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA34664 Issued in NJ
Practice address
150 Main St
Woodbridge, NJ 07095-2108
Phone
(732) 750-9444
Fax
(908) 654-3639
NPI assigned
Sep 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA34664 NJ Primary

Addresses

Primary practice location

150 Main St
Woodbridge, NJ 07095-2108

Mailing address

150 Main St
Woodbridge, NJ 07095-2108
Phone (732) 750-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430000882 NJ Practitioner - Ophthalmology 3375530256 Practice locations: Woodbridge, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA34664NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942304969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952108",
            "telephone_number": "732-750-9444",
            "fax_number": "908-654-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952108",
            "telephone_number": "732-750-9444",
            "fax_number": "908-654-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA34664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

Verify at the official NPI Registry.