Healthcare Provider Details

I. General information

NPI: 1124756697
Provider Name (Legal Business Name): LONCKE INDUSTRIES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 ROGER RD
EDISON NJ
08817-4532
US

IV. Provider business mailing address

24 ROGER RD
EDISON NJ
08817-4532
US

V. Phone/Fax

Practice location:
  • Phone: 347-616-0327
  • Fax:
Mailing address:
  • Phone: 347-616-0327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FREDERICA S PIERRE
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 347-616-0327