Nicole L Lacz Diagnostic Radiology
116 Park St, Montclair, NJ 07042-2930


Nicole L Lacz is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1306052246. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 1153599055. The primary specialty is DIAGNOSTIC RADIOLOGY. The organization is MONTCLAIR RADIOLOGICAL ASSOC PA. The address is 116 Park St, Montclair, NJ 07042-2930. The zip code is 07042.


Nicole L Lacz · 116 Park St, Montclair, NJ 07042-2930

Nation Provider ID 1306052246
PAC ID by PECOS 1153599055
Professional Enrollment ID I20110720000451
Last Name LACZ
First Name NICOLE
Middle Name L
Gender F
Medical School Name UMDNJ-NEW JERSEY MEDICAL SCHOOL
Graduation Year 2004
Primary Specialty DIAGNOSTIC RADIOLOGY
Primary Specialty MONTCLAIR RADIOLOGICAL ASSOC PA
Phone Number 9737462525
Group Practice PAC ID 3274507447
Number of Group Practice Members 16
Address 116 PARK ST
MONTCLAIR, NJ 070422930
Claims Based Hospital Affiliation Claim Control Number (CCN): 310017
Legal Business Name: CHILTON MEDICAL CENTER
Claims Based Hospital Affiliation Claim Control Number (CCN): 310015
Legal Business Name: MORRISTOWN MEDICAL CENTER
Professional accepts Medicare Assignment Y
Report Quality Measures Y

Montclair Radiological Assoc Pa · Medicare Physician

Name Address Specialty
Ross Mondshine 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Michael Pollack 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Lisa Bash 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Anuj Tolia 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Denise Mcfadden 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Stuart Moses 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Konstantin Krepkin 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Brett Ferdinand 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Patrick Hines 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Jessica Torrente 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Sarah Dodge 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Daniel Levy 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Mala Shah 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY

Zip 07042 · Diagnostic Radiology · Medicare Physician

Name Address Specialty
Stacey Vitiello 37 N Fullerton Ave, Montclair, NJ 07042-3446 DIAGNOSTIC RADIOLOGY
Joo Young Lee 37 N Fullerton Ave, Montclair, NJ 07042-3446 DIAGNOSTIC RADIOLOGY
Lisa Bash 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Daniel Levy 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Stuart Moses 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Denise Mcfadden 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Ross Mondshine 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY

Zip 07042 · Medicare Physician

Name Address Specialty
Demi Turner 313 Orange Rd, Montclair, NJ 07042-4451 PODIATRY
Lynn Simon 1 Greenwood Ave, Montclair, NJ 07042-3649 OCCUPATIONAL THERAPY
Alvin Bell 129 Grove St, Montclair, NJ 07042-4049 NEPHROLOGY
Patrick Dipaolo 781 Bloomfield Ave, Montclair, NJ 07042-1806 HEMATOLOGY/ONCOLOGY
Mark Dodd 101 Park St, Montclair, NJ 07042-2963 CLINICAL SOCIAL WORKER
Casey Ashby 1 Greenwood Ave, Montclair, NJ 07042-3649 OCCUPATIONAL THERAPY
Jaclyn Kopidlowski 49 Claremont Ave, Montclair, NJ 07042-4854 OCCUPATIONAL THERAPY
Mary Carrillo 1 Bay Ave, Montclair, NJ 07042-4837 CERTIFIED REGISTERED NURSE ANESTHETIST
Ross Mondshine 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Edward Latimer 24 Portland Pl, Montclair, NJ 07042-2822 PSYCHIATRY
Hetal Patel 160 Walnut St, Montclair, NJ 07042-3802 CRITICAL CARE (INTENSIVISTS)
Hakeem Tijani 1 Bay Ave, Montclair, NJ 07042-4837 INTERNAL MEDICINE
Mollie Sherman 1 Greenwood Ave, Montclair, NJ 07042-3649 OCCUPATIONAL THERAPY
Neal Yudkoff 119 Grove St, Montclair, NJ 07042-4044 PODIATRY
Nikola Kuzmanovski 86 Valley Rd, Montclair, NJ 07042-2209 PHYSICAL THERAPY
David Goldstein 1 Bay Ave, Montclair, NJ 07042-4837 GASTROENTEROLOGY
Michelle Medina 1 Bay Ave, Montclair, NJ 07042-4837 CERTIFIED REGISTERED NURSE ANESTHETIST
Joseph Ivan 1 Bay Ave, Montclair, NJ 07042-4837 OBSTETRICS/GYNECOLOGY
Alapatt Thomas 127 Pine St, Montclair, NJ 07042-4868 INTERNAL MEDICINE
Annie Giszpenc 93 Montclair Ave, Montclair, NJ 07042-4128 CLINICAL SOCIAL WORKER