Individual
MADISON LACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 ROUTE 23, SUITE 1C, HAMBURG, NJ 07419
(973) 209-1550
(973) 209-4832
Mailing address
532 LAFAYETTE RD STE 300, SPARTA, NJ 07871-4411
(973) 795-4554
(973) 940-0399
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15125800
NJ
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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