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Organization

MOUNTAIN LAKES FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRENDA LESLIE ZIEGLER D.O. (PRESIDENT)
(973) 334-3773
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB06311200
NJ

Other

Enumeration date
08/31/2009
Last updated
08/31/2009
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