# LISA C. DIMEDIO, D.O., P. C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982762381
- **Authorized official:** DR. LISA DIMEDIO D.O. (PRESIDENT)
- **Authorized official phone:** (856) 227-8611

## Contact information

- **Practice address:** 1652 COOPER ST, WOODBURY, NJ 08096-3768
- **Practice address phone:** (856) 227-8611
- **Practice address fax:** (856) 227-5716
- **Mailing address:** 1652 COOPER ST, WOODBURY, NJ 08096-3768
- **Mailing address phone:** (856) 227-8611
- **Mailing address fax:** (856) 227-5716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 25MB06370800 | NJ | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 11/30/2010