Provider Demographics
NPI:1205501871
Name:DLB MEDICAL LLC
Entity type:Organization
Organization Name:DLB MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BADER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:732-522-4868
Mailing Address - Street 1:1443 OTTAWA CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2962
Mailing Address - Country:US
Mailing Address - Phone:732-522-4868
Mailing Address - Fax:732-255-5659
Practice Address - Street 1:1443 OTTAWA CT
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2962
Practice Address - Country:US
Practice Address - Phone:732-522-4868
Practice Address - Fax:732-255-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No251E00000XAgenciesHome Health