Lisa Marie Degorostiza, A.P.N
Nurse Practitioner, Adult Health in Hoboken, NJ. Individual provider (NPI-1).
NPI number1487048476
StatusActive
Last updated in NPPESSep 22, 2016
Details
- NPI
- 1487048476
- Entity type
- Individual (NPI-1)
- Name
- Lisa Marie Degorostiza
- Credential
- A.P.N
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2015
- Last updated
- Sep 22, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | 26NJ00547600 | NJ | Yes |
| 363LG0600X | Nurse Practitioner, Gerontology | 26NJ00547600 | NJ |
Practice location
124 Grand StHoboken, NJ 07030-2510
Phone 201-963-0300
Mailing address
124 Grand StHoboken, NJ 07030-2510
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