Provider Demographics
NPI:1629110515
Name:LCASSISTS
Entity Type:Organization
Organization Name:LCASSISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:856-596-2693
Mailing Address - Street 1:2 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8849
Mailing Address - Country:US
Mailing Address - Phone:856-596-2693
Mailing Address - Fax:856-596-2693
Practice Address - Street 1:2 ASHLEY CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8849
Practice Address - Country:US
Practice Address - Phone:856-596-2693
Practice Address - Fax:856-596-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N005787400163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1629110515OtherNPI ID
NJ26N005787400OtherNJ LICENSE
NJ1629110515OtherNPI ID