Individual
LISA HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 PROSPECT AVE, HACKENSACK, NJ 07601-1997
(551) 996-2000
Mailing address
20 PROSPECT AVE, HACKENSACK, NJ 07601-1997
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR19896800
NJ
163W00000X
Registered Nurse
669305
NY
363LA2100X
Acute Care Nurse Practitioner
007470
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00902400
NJ
363LA2100X
Acute Care Nurse Practitioner
F430992
NY
Other
Enumeration date
03/09/2015
Last updated
01/22/2022
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