Provider Demographics
NPI:1760532857
Name:DENMARK, LOIS A (CA (NJ), LAC(NY))
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:A
Last Name:DENMARK
Suffix:
Gender:F
Credentials:CA (NJ), LAC(NY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CEDAR GREEN LN
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2410
Mailing Address - Country:US
Mailing Address - Phone:908-286-0339
Mailing Address - Fax:908-286-0232
Practice Address - Street 1:16 CEDAR GREEN LN
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2410
Practice Address - Country:US
Practice Address - Phone:908-286-0339
Practice Address - Fax:908-286-0232
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ000102171100000X
NY1075-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist