Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 25MB07726800 | NJ |
NPI | 1467640458 |
---|---|
Provider Name | Lisa A Drago |
First Address | Camden, NJ 08103-1438 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01004598200 | AMERICHOICE (01) | NJ |
0144584 | (05) | NJ |
1658893 | AETNA (01) | NJ |
2840720 | UNITED HEALTHCARE (01) | NJ |
3422995000 | AMERIHEALTH/KEYSTONE/IBC (01) | NJ |
60035046 | HORIZON NJ HEALTH (01) | NJ |
7471024 | CIGNA (01) | NJ |