Individual
THERESE LIZARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
165 PARLIN LN, WATCHUNG, NJ 07069-5400
(908) 757-2149
Mailing address
165 PARLIN LN, WATCHUNG, NJ 07069-5400
(202) 302-4765
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA09642100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2015
Last updated
06/04/2019
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