Provider Demographics
NPI:1396891636
Name:REALE, LAUREN (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:REALE
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SHORELINE RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-8111
Mailing Address - Country:US
Mailing Address - Phone:570-855-9921
Mailing Address - Fax:
Practice Address - Street 1:450 TILTON RD STE 110
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1258
Practice Address - Country:US
Practice Address - Phone:609-641-1963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00089600231H00000X
NJ25MG00138400237600000X
PAAT005910237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist