Individual
LISA MARIE BRANDEFINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FRANCES CT, RED BANK, NJ 07701-6219
(646) 413-9966
Mailing address
1 FRANCES CT, RED BANK, NJ 07701-6219
(646) 413-9966
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1369921
NY
Other
Enumeration date
01/12/2022
Last updated
01/13/2022
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