# MOUNTAIN LAKES FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326271826
- **Authorized official:** DR. BRENDA LESLIE ZIEGLER D.O. (PRESIDENT)
- **Authorized official phone:** (973) 334-3773

## Contact information

- **Practice address:** 420 BOULEVARD, SUITE 104, MOUNTAIN LAKES, NJ 07046-1742
- **Practice address phone:** (973) 334-3773
- **Practice address fax:** (973) 334-2109
- **Mailing address:** 420 BOULEVARD, SUITE 104, MOUNTAIN LAKES, NJ 07046-1742
- **Mailing address phone:** (973) 334-3773
- **Mailing address fax:** (973) 334-2109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 25MB06311200 | NJ | Yes |

## Other

- **Enumeration date:** 08/31/2009
- **Last updated:** 08/31/2009