Individual
DR. LISA M DERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
240 WILLIAMSON ST, STE 104, ELIZABETH, NJ 07202-3671
(908) 994-5480
Mailing address
240 WILLIAMSON ST, STE 104, ELIZABETH, NJ 07202-3671
(856) 796-9200
(856) 796-9397
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MB08941100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270661
—
NJ
Enumeration date
08/01/2007
Last updated
03/23/2017
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