Individual
LISA CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25B VREELAND RD, FLORHAM PARK, NJ 07932-1900
(973) 660-9334
Mailing address
25B VREELAND RD, PO BOX 0037, FLORHAM PARK, NJ 07932-1900
(973) 660-9334
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05839500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5304008
—
NJ
Enumeration date
11/21/2006
Last updated
05/23/2024
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