Lisa Marie Brandefine
Specialist in Red Bank, NJ. Individual provider (NPI-1).
NPI number1508517467
StatusActive
Last updated in NPPESJan 13, 2022
Details
- NPI
- 1508517467
- Entity type
- Individual (NPI-1)
- Name
- Lisa Marie Brandefine
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 12, 2022
- Certification date
- Jan 13, 2022
- Last updated
- Jan 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 1369921 | NY | Yes |
Practice location
1 Frances CtRed Bank, NJ 07701-6219
Phone 646-413-9966
Mailing address
1 Frances CtRed Bank, NJ 07701-6219
Phone 646-413-9966
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