Individual
LISA GRANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
433 BELLEVUE AVE, TRENTON, NJ 08618-4514
(609) 394-4111
(609) 394-4070
Mailing address
433 BELLEVUE AVE, TRENTON, NJ 08618-4514
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA05975500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5573700
—
NJ
Enumeration date
06/23/2006
Last updated
04/27/2021
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