Provider Demographics
NPI:1770585689
Name:VECE, LORRIE JUNE (MD)
Entity type:Individual
Prefix:DR
First Name:LORRIE
Middle Name:JUNE
Last Name:VECE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LORRIE
Other - Middle Name:JUNE
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:185 CEDAR LN
Mailing Address - Street 2:SUITE U 4
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4316
Mailing Address - Country:US
Mailing Address - Phone:201-836-1919
Mailing Address - Fax:201-836-5693
Practice Address - Street 1:185 CEDAR LN
Practice Address - Street 2:SUITE U 4
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4316
Practice Address - Country:US
Practice Address - Phone:201-836-1919
Practice Address - Fax:201-836-5693
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA058549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5267404Medicaid
NJ5267404Medicaid