Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 40QA85700 | NJ |
Y | 213ES0000X | Sports Medicine | 40QA85700 | NJ |
NPI | 1407484538 |
---|---|
Provider Name | Lisa Geller |
First Address | Morristown, NJ 07960-6097 |
Second Address | Morristown, NJ 07960-6097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2020 |
Last Update Date | 01/04/2020 |