Individual
DR. LARISA KAYSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3957
(201) 612-9600
(201) 612-0428
Mailing address
1200 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3957
(201) 612-9600
(201) 612-0428
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA06139100
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
25MA06139100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6798608
—
NJ
Enumeration date
03/14/2006
Last updated
09/21/2023
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