Individual
LISA BODOLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 CEDAR LN, TEANECK, NJ 07666-3441
(201) 541-8600
Mailing address
27 ORCHARD RD, MAPLEWOOD, NJ 07040-1919
(513) 617-4439
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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