Organization
SHERIDAN CANNONLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MARIE CANNON M.D (PHYSICIAN)
(201) 251-2525
Entity
Organization
Contact information
Practice address
110 WARREN AVE, HO HO KUS, NJ 07423-1566
(201) 251-2525
(201) 251-8488
Mailing address
PO BOX 158, WYCKOFF, NJ 07481-0158
(201) 251-2525
(201) 251-8488
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MA69017
NJ
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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