Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ01245300 | NJ |
NPI | 1073274049 |
---|---|
Provider Name | Ms. Lisa Scarlatella |
First Address | Madison, NJ 07940-1006 |
Second Address | Madison, NJ 07940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |