Provider Demographics
NPI:1699267948
Name:HERRING, TRACY LYNETTE (PHLEBOTOMIST)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNETTE
Last Name:HERRING
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MOCHEN CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2205
Mailing Address - Country:US
Mailing Address - Phone:732-621-6626
Mailing Address - Fax:732-707-3091
Practice Address - Street 1:2 MOCHEN CT
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-2205
Practice Address - Country:US
Practice Address - Phone:732-621-6626
Practice Address - Fax:732-707-3091
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-02
Last Update Date:2018-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ82-2692135246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty