| Doctor Name: | DERK REPLOGLE |
| NPI Number: | 1518373463 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCADC |
| License Number: | 37LC00183300 |
| Business Practice Address: | 1801 Greenwood Lake Tpke Hewitt, NJ - 074213008 |
| Business Phone Number: | 9737283938 |
| Business Fax Number: | |
| Mailing Address: | 7 Industrial Rd, PEQUANNOCK |
| State: | NJ |
| Postal Code: | 074401901 |
| Phone Number: | 9738392520 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2014 |
| NPI Last Update Date: | 07/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 37LC00183300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |