Individual
LISA KAUSHAL TANK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, DIVISION OF GERIATRICS, HACKENSACK, NJ 07601-1914
(201) 678-2994
(201) 678-2976
Mailing address
30 PROSPECT AVE, DIVISION OF GERIATRICS, HACKENSACK, NJ 07601-1914
(201) 678-2994
(201) 678-2976
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MA073309
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8850801
—
NJ
Enumeration date
05/25/2006
Last updated
07/08/2007
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