Provider Demographics
NPI:1366914442
Name:BIEGEL, TRACY (LAC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BIEGEL
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 1:34 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2306
Mailing Address - Country:US
Mailing Address - Phone:551-265-9728
Mailing Address - Fax:
Practice Address - Street 1:2 ARNOT ST STE 3
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1630
Practice Address - Country:US
Practice Address - Phone:973-472-5433
Practice Address - Fax:973-472-5433
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00135700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist