Individual
LISE MIRLINE DOMMERCANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1553 DAY TER, UNION, NJ 07083-4719
(908) 209-7910
Mailing address
1553 DAY TER, UNION, NJ 07083-4719
(908) 209-7910
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26BJ15533800
NJ
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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