Individual
LACEY M HERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1086 TEANECK RD STE 4C, TEANECK, NJ 07666-4855
(201) 837-9449
(201) 578-1699
Mailing address
1086 TEANECK RD STE 4C, TEANECK, NJ 07666-4855
(201) 837-3443
(201) 578-1699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00259500
NJ
Other
Enumeration date
08/01/2011
Last updated
09/02/2021
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