1700088549 NPI number — MRS. ERIN LANG FUCCI

Table of content: MRS. ERIN LANG FUCCI (NPI 1700088549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700088549 NPI number — MRS. ERIN LANG FUCCI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FUCCI
Provider First Name:
ERIN
Provider Middle Name:
LANG
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1700088549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 E VINEYARD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAPE MAY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08204-4277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-898-2293
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3860 BAYSHORE RD
Provider Second Line Business Practice Location Address:
BACHARACH REHABILITATION
Provider Business Practice Location Address City Name:
NORTH CAPE MAY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08204-3260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-770-7804
Provider Business Practice Location Address Fax Number:
609-770-7853
Provider Enumeration Date:
06/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  40QA00623600 , 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)