Provider Demographics
NPI:1013392174
Name:VOGLER, TRACI M
Entity Type:Individual
Prefix:DR
First Name:TRACI
Middle Name:M
Last Name:VOGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 OVAL RD
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1409
Mailing Address - Country:US
Mailing Address - Phone:814-232-2219
Mailing Address - Fax:
Practice Address - Street 1:37 OVAL RD
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1409
Practice Address - Country:US
Practice Address - Phone:814-232-2219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00683700174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian