Free National NPI Number Registry

Dr. Lyle Marnin Back

Home >Dr. Lyle Marnin Back

 

NPI Number Detailed Information

Provider Information:

Name: Dr. Lyle Marnin Back
Gender: M
Provider License Number If Given: MA046399

NPI Information:

NPI: 1639172679
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 1942 ROUTE 70 E
Cherry Hill, NJ 08003
Phone Number: 8567517550
Fax Number: 8567517544

Provider Business Practice Location Address:

Address: 1942 ROUTE 70 E
Cherry Hill, NJ 08003
Phone Number: 8567517550
Fax Number: 8567517544

Provider Taxonomy:

Primary: 208200000X
Secondary (if any):
State: NJ