Individual
LISA GISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
23-00 NJ208 SUITE 2-9, FAIR LAWN, NJ 07410
(201) 625-1500
Mailing address
23-00 NJ208 SUITE 2-9, FAIR LAWN, NJ 07410
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
50664
NJ
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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