Nicole L Lacz (NPI# 1306052246, PAC ID# 1153599055) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1306052246 |
| PAC ID by PECOS | 1153599055 |
| Professional Enrollment ID | I20110720000451 |
| Full Name | Nicole L Lacz |
| Organization Legal Name | MONTCLAIR RADIOLOGICAL ASSOC PA |
| Address |
116 Park St Montclair NJ 07042-2930 |
| Phone Number | 9737462525 |
| Gender | F |
| Medical School | UMDNJ-NEW JERSEY MEDICAL SCHOOL |
| Graduation Year | 2004 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 3274507447 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310017 | CHILTON MEDICAL CENTER |
| 310015 | MORRISTOWN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 116 Park St, Montclair, NJ 07042-2930 | 9737462525 | MONTCLAIR RADIOLOGICAL ASSOC PA |
| 20 High St, Nutley, NJ 07110-1132 | 9732841881 | MONTCLAIR RADIOLOGICAL ASSOC PA |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 0% |
| Organization Legal Name | MONTCLAIR RADIOLOGICAL ASSOC PA |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mala Shah | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Mark Burshteyn | Diagnostic Radiology | Montclair Radiological Assoc Pa | 20 High St, Nutley, NJ 07110-1132 |
| Denise C Mcfadden | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Patrick Hines | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Sue Y Kim | Diagnostic Radiology | Montclair Radiological Assoc Pa | 1140 Bloomfield Ave, West Caldwell, NJ 07006-7130 |
| Anuj J Tolia | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Lisa T Bash | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Konstantin Krepkin | Diagnostic Radiology | Montclair Radiological Assoc Pa | 1140 Bloomfield Ave, West Caldwell, NJ 07006-7130 |
| Brett D Ferdinand | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Ross T Mondshine | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Street Address |
116 PARK ST |
| City | MONTCLAIR |
| State | NJ |
| Zip | 07042-2930 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mala Shah | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Denise C Mcfadden | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Patrick Hines | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Anuj J Tolia | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Lisa T Bash | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Brett D Ferdinand | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Ross T Mondshine | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Daniel S Levy | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Jeffrey J Plutchok | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Michael Pollack | Diagnostic Radiology | Montclair Radiological Assoc Pa | 116 Park St, Montclair, NJ 07042-2930 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Arnaldo Apolito | Psychiatry | 80 Undercliff Rd, Montclair, NJ 07042-1718 | |
| Kristine T Kaufman | Physical Therapy | Varsha Pohuja LLC | 403 Claremont Ave, Montclair, NJ 07042-1801 |
| Patrick Dipaolo | Hematology/oncology | 781 Bloomfield Ave, Montclair, NJ 07042-1806 | |
| Shae Cali | Clinical Social Worker | 1 Upper Mountain Ave, Montclair, NJ 07042-1871 | |
| Robert Friedman | Clinical Social Worker | 30 Orange Rd, Montclair, NJ 07042-2110 | |
| Marisol Vazquez | Registered Dietitian Or Nutrition Professional | Back To Basics Nutrition Counseling, LLC | 8 Hillside Ave, Suite 207, Montclair, NJ 07042-2129 |
| Linda A Ditullio | Clinical Social Worker | 8 Hillside Ave, Suite 108 6, Montclair, NJ 07042-2129 | |
| Beth Dibiase Fiorarancio | Clinical Social Worker | 8 Hillside Ave, Suite 206, Montclair, NJ 07042-2129 | |
| Megan Marchaterre | Registered Dietitian Or Nutrition Professional | Back To Basics Nutrition Counseling, LLC | 8 Hillside Ave, Suite 207, Montclair, NJ 07042-2129 |
| Faith C Dunkel | Psychologist, Clinical | 8 Hillside Ave, Suite 108, Montclair, NJ 07042-2129 | |
| Find all physicians in zip 07042 | |||
| City | MONTCLAIR |
| Zip Code | 07042 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | MONTCLAIR + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Nicole L Lacz.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.