Individual
LISA CASSIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
201 LYONS AVE, SUITE G5, NEWARK, NJ 07112-2027
(973) 926-7749
(973) 923-4683
Mailing address
201 LYONS AVE, SUITE C1, NEWARK, NJ 07112-2027
(973) 926-4430
(973) 926-5658
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
26NJ00075100
NJ
363LF0000X
Family Nurse Practitioner
26NJ00075100
NJ
Other
Enumeration date
03/09/2006
Last updated
01/03/2014
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