Individual
LISA DIANA JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1358 56TH ST, BROOKLYN, NY 11219-4616
(929) 372-9133
Mailing address
1358 56TH. STREET, BROOKLYN, NY 11219
(929) 372-9133
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
526551
NY
163WC0400X
Case Management Registered Nurse
526551-1
NY
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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