Individual
LISA MARIE DEGOROSTIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N
Contact information
Practice address
124 GRAND ST, HOBOKEN, NJ 07030-2510
(201) 963-0300
Mailing address
124 GRAND ST, HOBOKEN, NJ 07030-2510
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00547600
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ00547600
NJ
Other
Enumeration date
03/27/2015
Last updated
09/22/2016
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