Granderson, Lisa

Granderson, Lisa is an individual health care provider with primary practice located at 433 Bellevue Ave , Trenton NJ 08618-4514. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Granderson, Lisa can be contacted via phone (609) 394-4111.

Contact Information

Primary practice address
433 Bellevue Ave Trenton NJ 08618-4514
Phone: (609) 394-4111
Fax: (609) 394-4070
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 25MA05975500 New Jersey

Profile Details

NPI number 1508892324
LBN Legal business name Granderson, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Apr 27th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508892324 NPPES
New Jersey MEDICAID 5573700

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