Individual
LISA TUMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74 CEDAR LN # 184, ROSELLE, NJ 07203-3006
(201) 259-6630
Mailing address
74 CEDAR LN # 184, ROSELLE, NJ 07203-3006
(201) 259-6630
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32WG00789000
NJ
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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