Provider Demographics
NPI:1144097015
Name:PRESTIGE - LACHENMAYR LLC
Entity type:Organization
Organization Name:PRESTIGE - LACHENMAYR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAMDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-219-9197
Mailing Address - Street 1:1150 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ALPHA
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-4787
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 3RD AVE
Practice Address - Street 2:
Practice Address - City:ALPHA
Practice Address - State:NJ
Practice Address - Zip Code:08865-4787
Practice Address - Country:US
Practice Address - Phone:908-454-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental