Individual
DR. LISA KIM ELLMAN-GRUNTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 BROADWAY RM 713, NEW YORK, NY 10038-4334
(646) 854-3002
(646) 493-7299
Mailing address
PO BOX 11205, FAIRFIELD, NJ 07004-7205
(646) 854-3002
(646) 493-7299
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
25MMAO7471600
NJ
Other
Enumeration date
05/02/2006
Last updated
11/05/2024
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