| Lacey Medical Group, Llc | |
|
1044 Lacey Rd Ste 9 Forked River NJ 08731-1051 | |
| (609) 693-0819 | |
| (609) 971-0834 |
| Full Name | Lacey Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1044 Lacey Rd Ste 9, Forked River, New Jersey |
| Authorized Official Name and Position | Ann Dipaolo (OWNER) |
| Authorized Official Contact | 6096930819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacey Medical Group, Llc 1044 Lacey Rd Ste 9 Forked River NJ 08731-1051 Ph: (609) 693-0819 | Lacey Medical Group, Llc 1044 Lacey Rd Ste 9 Forked River NJ 08731-1051 Ph: (609) 693-0819 |
| NPI Number | 1487091369 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 1557503521 |
|---|---|
| Medicare Enrollment ID | O20130805000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487091369 | NPI | - | NPPES |
| 0052680 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB07677400 (New Jersey) | Primary |
| Provider Name | Ann Dipaolo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285604041 PECOS PAC ID: 9234191818 Enrollment ID: I20041027000717 |
| Provider Name | Eulalia Dibattiste |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104856434 PECOS PAC ID: 4981733417 Enrollment ID: I20100521000492 |
| Provider Name | Sandra L Wiercinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427392711 PECOS PAC ID: 9133373046 Enrollment ID: I20130131000031 |
William K. Power, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 Lacey Rd, Suite G06, Forked River, NJ 08731 Phone: 609-693-9240 Fax: 609-693-3616 | |
Wharfside Chiropractic Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 Hollywood Blvd, Ste. A, Forked River, NJ 08731 Phone: 609-971-7733 Fax: 609-693-7623 | |
Nina L. Tubilleja, Md, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 403 Penn Ave., Forked River, NJ 08731 Phone: 609-971-9392 | |
Joel P Jannone Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Lacey Rd, Forked River, NJ 08731 Phone: 609-242-0040 Fax: 609-242-1019 | |
Quality Medical Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1044 Lacey Rd, Forked River, NJ 08731 Phone: 609-693-5006 Fax: 609-693-5016 | |
Lacey Family Medicine, L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 833 Lacey Rd, Suite 6, Forked River, NJ 08731 Phone: 609-242-6700 Fax: 609-242-6701 | |
Liviu Crisan M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 651 Lacey Rd, Forked River, NJ 08731 Phone: 609-242-4322 Fax: 609-242-4324 |