Lifestyles Medical
Lifestyles Medical is a Clinical Social Worker in West Long Branch, New Jersey. Licensed in New Jersey. Registered with an NPI since 2014.
- Licensed in
- NJ
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
107 Monmouth Rd Ste 104 DWest Long Branch, NJ 07764-1021
Phone: (732) 542-2638
Fax: (732) 542-2620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X · Licence 25MB07769000 (NJ) |
|---|---|
| Clinical Social Worker | Taxonomy 1041C0700X · Licence 44SC05539700 (NJ) |
Record details
| NPI number | 1699188359 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Rand Salani — Admin · (732) 542-2638 |
| NPI enumerated | June 10, 2014 |
| Last updated in NPPES | June 10, 2014 |
| Mailing address | 107 Monmouth Rd, Suite 104 D, West Long Branch, NJ 07764-1021 |
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Mrs. Rachel Lynn Fornicola, LCSW
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MS. Ashley Nicole Gwathney, LCSW
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