Individual
LISA MARIE KOUMOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
92 SUMMIT AVE, HACKENSACK, NJ 07601-1263
(201) 342-0066
Mailing address
92 SUMMIT AVE, HACKENSACK, NJ 07601-1263
(551) 206-8615
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ01081600
NJ
Other
Enumeration date
12/04/2020
Last updated
12/11/2025
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