Provider Demographics
NPI:1043845548
Name:NEIGHBORHOOD HEALTH AND WEIGHT MEDICAL, LLC
Entity type:Organization
Organization Name:NEIGHBORHOOD HEALTH AND WEIGHT MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA LOURDES
Authorized Official - Middle Name:TRONCALES
Authorized Official - Last Name:MALICDEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-513-8063
Mailing Address - Street 1:PO BOX 770577
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-0029
Mailing Address - Country:US
Mailing Address - Phone:810-513-8063
Mailing Address - Fax:
Practice Address - Street 1:27014 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4045
Practice Address - Country:US
Practice Address - Phone:810-513-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty