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General NPI Number Information
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NPI Number | 1205501871
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Entity Type | Organization
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Legal Business Name | DLB MEDICAL LLC
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Dates
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Enumeration Date | 08/14/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 1443 OTTAWA CT
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2962
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Country | US
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Telephone | 732-522-4868
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Fax | 732-255-5659
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Provider Business Mailing Address
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Address Line | 1443 OTTAWA CT
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2962
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Country | US
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Telephone | 732-522-4868
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Fax | 732-255-5659
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH BADER
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Credential | NP
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Telephone | 732-522-4868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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