Individual
KAYLA LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
325 PRINCETON AVE, PRINCETON, NJ 08540-1698
(609) 924-8131
(609) 924-8532
Mailing address
325 PRINCETON AVE, PRINCETON, NJ 08540-1698
(609) 924-8131
(609) 924-8532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00409800
NJ
Other
Enumeration date
09/13/2016
Last updated
09/26/2024
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