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Individual

DR. LISA MARIE GUDICELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
440 NORTHERN PKWY, RIDGEWOOD, NJ 07450-1721
(201) 220-2654
(201) 220-2654
Mailing address
440 NORTHERN PKWY, RIDGEWOOD, NJ 07450-1721
(201) 220-2654
(201) 220-2654

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
318455
NY
207W00000X
Ophthalmology Physician
MA06926700
NJ

Other

Enumeration date
01/11/2007
Last updated
01/26/2023
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