Provider Demographics
NPI:1023179041
Name:LEFAND, LAURA F (DC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:F
Last Name:LEFAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PLAZA ROAD
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9416
Mailing Address - Country:US
Mailing Address - Phone:973-584-4499
Mailing Address - Fax:973-584-2201
Practice Address - Street 1:28 PLAZA ROAD
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9416
Practice Address - Country:US
Practice Address - Phone:973-584-4499
Practice Address - Fax:973-584-2201
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00408900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
690769Medicare ID - Type Unspecified