| Geri Lane Llc | |
|
115 Route 46 W Ste B11 Mountain Lakes NJ 07046-1656 | |
| (908) 625-0925 | |
| Not Available |
| Full Name | Geri Lane Llc |
|---|---|
| Speciality | Counselor |
| Location | 115 Route 46 W Ste B11, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Geraldine Lane (OWNER) |
| Authorized Official Contact | 9086250925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geri Lane Llc 96 James St Morristown NJ 07960-5903 Ph: (908) 625-0925 | Geri Lane Llc 115 Route 46 W Ste B11 Mountain Lakes NJ 07046-1656 Ph: (908) 625-0925 |
| NPI Number | 1275308132 |
|---|---|
| Provider Enumeration Date | 11/21/2023 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Medicare PECOS PAC ID | 4587013495 |
|---|---|
| Medicare Enrollment ID | O20231218000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275308132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Geraldine Lane |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245713403 PECOS PAC ID: 3577912484 Enrollment ID: I20231218000511 |
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