O'Donnell, Lisa M

O'Donnell, Lisa M is an individual health care provider with primary practice located at 18 Railroad Ave Suite 103, Rochelle Park NJ 07662-4105. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. O'Donnell, Lisa M can be contacted via phone (201) 928-0748.

Contact Information

Primary practice address
18 Railroad Ave Suite 103 Rochelle Park NJ 07662-4105
Phone: (201) 928-0748
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA07968400 New Jersey

Profile Details

NPI number 1487723300
LBN Legal business name O'Donnell, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jan 22nd, 2013 - about 13 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 1487723300 NPPES
New Jersey MEDICAID 0279676

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