Individual
DEBBIE LACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
127 AYERS CT, STE F2, TEANECK, NJ 07666-5152
(201) 471-1034
Mailing address
127 AYERS CT, STE F2, TEANECK, NJ 07666-5152
(201) 471-1034
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
L00521577756692
NJ
374U00000X
Home Health Aide
821012965
NJ
Other
Enumeration date
10/07/2016
Last updated
04/28/2017
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