Provider Demographics
NPI:1306276548
Name:LICHTENFELD, DANIELLE ELYSE (LAC)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:ELYSE
Last Name:LICHTENFELD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1003
Mailing Address - Country:US
Mailing Address - Phone:732-449-2001
Mailing Address - Fax:
Practice Address - Street 1:2123 ROUTE 35
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1003
Practice Address - Country:US
Practice Address - Phone:732-449-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00103400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist