Individual
MR. LAWRENCE WILLIAM NISIVOCCIA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 LYN GALE CT, WASHINGTON, NJ 07882-4111
(908) 835-8656
Mailing address
14 LYN GALE CT, WASHINGTON, NJ 07882-4111
(908) 835-8656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA00727500
NJ
Other
Enumeration date
12/14/2006
Last updated
01/07/2009
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