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General NPI Number Information
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NPI Number | 1003080169
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Entity Type | Organization
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Legal Business Name | ANNANDALE FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 56 PAYNE RD SUITE 21
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City | LEBANON
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State | NJ
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Zip | 08833-3262
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Country | US
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Telephone | 908-238-0100
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Fax | 908-238-0951
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Provider Business Mailing Address
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Address Line | 56 PAYNE RD SUITE 21
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City | LEBANON
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State | NJ
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Zip | 08833-3262
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Country | US
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Telephone | 908-238-0100
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Fax | 908-238-0951
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | MRS. THERESA ANN SACCHIERI
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Credential | MD
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Telephone | 201-314-1139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA07764100
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License Number State | NJ
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