Individual
LISA M CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 N RTE 17, PARAMUS, NJ 07652-3000
(551) 218-3790
(201) 979-1312
Mailing address
2105 FREEMAN WAY, ALLENDALE, NJ 07401-1780
(201) 456-5367
(201) 979-1312
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA69017
NJ
207R00000X
Internal Medicine Physician
MA06901700
NJ
207RP1001X
Pulmonary Disease Physician
Primary
25MA06901700
NJ
Other
Enumeration date
05/09/2006
Last updated
10/27/2025
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