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NPI Code Detail

MEDICARE: LALITHA THERESE WALDRON HANSCH MD

MEDICARE: LALITHA THERESE WALDRON HANSCH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician25MA07190700NJ

General Provider Information

NPI Number : 1568462505
Entity Type Code : Individual
Provider Name (Legal Business Name) : LALITHA THERESE WALDRON HANSCH MD
Provider Business Mailing Address
First Line : 110 REHILL AVE
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-2519
Country : US
Telephone Number : 908-685-2900
Fax Number : 908-203-5964
Provider Business Practice Location Address
First Line : 110 REHILL AVE
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-2519
Country : US
Telephone Number : 908-685-2900
Fax Number : 908-203-5964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 04/07/2021

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Directions to “ LALITHA THERESE WALDRON HANSCH MD” Practice Location

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