1649594771 NPI number — MARCIA D. LITE-BRAUS, LPC, LLC

Table of content: (NPI 1649594771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649594771 NPI number — MARCIA D. LITE-BRAUS, LPC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARCIA D. LITE-BRAUS, LPC, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649594771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 JOHN F. KENNEDY PARKWAY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SHORT HILLS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-239-3073
Provider Business Mailing Address Fax Number:
973-467-7950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 JOHN F. KENNEDY PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SHORT HILLS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-239-3073
Provider Business Practice Location Address Fax Number:
973-467-7950
Provider Enumeration Date:
03/18/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LITE-BRAUS
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
908-239-3073

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  37PC00368600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)