Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 25MA07164200 | NJ |
NPI | 1134194624 |
---|---|
Provider Name | Dr. Lisa Abeshaus |
First Address | Voorhees, NJ 08043-8303 |
Second Address | Summit, NJ 07901-3562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E68899 | (02) | NJ |