Individual
LAN KYCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 SAGEMORE DR STE 205, MARLTON, NJ 08053-4332
(856) 985-3030
Mailing address
6 WILDERNESS DR, MEDFORD, NJ 08055-3808
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA06074600
NJ
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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