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Individual

LISA M GRIMALDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016
(602) 933-1784
(602) 933-1785
Mailing address
3200 E CAMELBACK RD, STE 250, PHOENIX, AZ 85018-2327
(602) 933-1813

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
25MA07959500
NJ
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
36853
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
C10012364
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0074624
NJ
05
250387785
DE
Enumeration date
12/07/2006
Last updated
10/30/2018
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