Nicole L Lacz Diagnostic Radiology
20 High St, Nutley, NJ 07110-1132


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 20 High St, Nutley, NJ 07110-1132. The zip code is 07110.


Nicole L Lacz · 20 High St, Nutley, NJ 07110-1132

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 9732841881
Group Practice PAC ID 3274507447
Number of Group Practice Members 16
Address 20 HIGH ST
NUTLEY, NJ 071101132
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
Lisa Bash 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Ross Mondshine 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY
Sarah Dodge 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Jessica Torrente 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Anuj Tolia 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Konstantin Krepkin 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
Patrick Hines 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Mala Shah 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Brett Ferdinand 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Michael Pollack 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Daniel Levy 116 Park St, Montclair, NJ 07042-2930 DIAGNOSTIC RADIOLOGY

Zip 07110 · Diagnostic Radiology · Medicare Physician

Name Address Specialty
Anuj Tolia 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Patrick Hines 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Sarah Dodge 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Andrew Kim 85 Franklin Ave, Nutley, NJ 07110-3273 DIAGNOSTIC RADIOLOGY
Konstantin Krepkin 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Michael Pollack 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Jessica Torrente 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Brett Ferdinand 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Mala Shah 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY

Zip 07110 · Medicare Physician

Name Address Specialty
Monica Carrero 610 Franklin Ave, Nutley, NJ 07110-1237 PHYSICAL THERAPY
Donna Pontoriero 299 Franklin Ave, Nutley, NJ 07110-2735 CHIROPRACTIC
Jan Youssef 115 Franklin Ave, Nutley, NJ 07110-2924 OTOLARYNGOLOGY
Eileen Doyle 363 Centre St, Nutley, NJ 07110-4706 CLINICAL SOCIAL WORKER
Patrick Hines 20 High St, Nutley, NJ 07110-1132 DIAGNOSTIC RADIOLOGY
Kelly Helm 160 Franklin Ave, Nutley, NJ 07110-3075 PHYSICAL THERAPY
Robert Lardiere 230 Centre St, Nutley, NJ 07110-2877 PODIATRY
Thomas Modica 189 Franklin Ave, Nutley, NJ 07110-2997 PHYSICAL THERAPY
Seth Queler 45 Franklin Ave, Nutley, NJ 07110-3224 ORTHOPEDIC SURGERY
Marissa Koziar 138 Beech St, Nutley, NJ 07110-2116 CLINICAL PSYCHOLOGIST
Monique Dzendzera 582 Franklin Ave, Nutley, NJ 07110-1253 PHYSICAL THERAPY
Edward Vecchione 181 Franklin Ave, Nutley, NJ 07110-3820 INTERNAL MEDICINE
Alan Goodman 115 Franklin Ave, Nutley, NJ 07110-2924 ALLERGY/IMMUNOLOGY
Sang Yoo 245 Hillside Ave, Nutley, NJ 07110-1629 PSYCHIATRY
George Zazzali 670 Franklin Ave, Nutley, NJ 07110-1259 PHYSICAL MEDICINE AND REHABILITATION
Danielle Thomson 25 High St, Nutley, NJ 07110-1131 PHYSICAL THERAPY
Felicia Gardner 155 Chestnut St, Nutley, NJ 07110-2311 CLINICAL SOCIAL WORKER
Patricia Politi 155 Chestnut St, Nutley, NJ 07110-2311 CLINICAL SOCIAL WORKER
Himani Shah 582 Franklin Ave, Nutley, NJ 07110-1253 PHYSICAL THERAPY
Walter Shurminsky 420 Centre St, Nutley, NJ 07110-1635 OPTOMETRY