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NPI Code Detail

MEDICARE: ALEXANDRA PANCHELLA LAC

MEDICARE: ALEXANDRA PANCHELLA LAC
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
1101YP2500XProfessional Counselor37AC00398100NJ

General Provider Information

NPI Number : 1902307317
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA PANCHELLA LAC
Provider Business Mailing Address
First Line : 233 PARK PL
Second Line :
City : AUDUBON
State : NJ
Zip : 08106-1223
Country : US
Telephone Number : 856-264-1956
Fax Number :
Provider Business Practice Location Address
First Line : 1103 SHEPPARD RD
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-4797
Country : US
Telephone Number : 856-264-1956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2018
Last Update Date : 02/13/2026

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Directions to “ ALEXANDRA PANCHELLA LAC” Practice Location

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