Individual
LISA R RAHAIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26 EAST RED BANK AVE, WOODBURY, NJ 08096
(856) 848-4464
(856) 848-8706
Mailing address
26 EAST RED BANK AVE, WOODBURY, NJ 08096
(856) 848-4464
(856) 848-8706
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26N008267700
NJ
363L00000X
Nurse Practitioner
26NJ00017200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129640
—
NJ
Enumeration date
09/22/2006
Last updated
06/14/2012
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