| Mountain Lakes Family Practice Llc | |
|
420 Boulevard Suite 104 Mountain Lakes NJ 07046-1742 | |
| (973) 334-3773 | |
| (973) 334-2109 |
| Full Name | Mountain Lakes Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 420 Boulevard, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Brenda Leslie Ziegler (PRESIDENT) |
| Authorized Official Contact | 9733343773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Lakes Family Practice Llc 420 Boulevard Suite 104 Mountain Lakes NJ 07046-1742 Ph: (973) 334-3773 | Mountain Lakes Family Practice Llc 420 Boulevard Suite 104 Mountain Lakes NJ 07046-1742 Ph: (973) 334-3773 |
| NPI Number | 1326271826 |
|---|---|
| Provider Enumeration Date | 08/31/2009 |
| Last Update Date | 08/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326271826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB06311200 (New Jersey) | Primary |
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