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General NPI Number Information
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NPI Number | 1629110515
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Entity Type | Organization
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Legal Business Name | LCASSISTS
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 2 ASHLEY CT
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City | MEDFORD
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State | NJ
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Zip | 08055-8849
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Country | US
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Telephone | 856-596-2693
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Fax | 856-596-2693
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Provider Business Mailing Address
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Address Line | 2 ASHLEY CT
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City | MEDFORD
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State | NJ
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Zip | 08055-8849
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Country | US
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Telephone | 856-596-2693
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Fax | 856-596-2693
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LORRAINE M CAMPANELLA
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Credential | RNFA
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Telephone | 856-596-2693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 26N005787400
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License Number State | NJ
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