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Individual

LISA MELANIE FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
(973) 972-9000
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
25MA05696300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7328401
NJ
Enumeration date
11/20/2006
Last updated
02/03/2022
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