Individual
LISA COSCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
315 WOOTTON ST, BOONTON, NJ 07005-1939
(973) 917-3088
Mailing address
7 CHEYENNE DR, MONTVILLE, NJ 07045-9702
(973) 334-5592
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00258800
NJ
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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