LISA WYDRA

HAZLET, NJ
NPI1780916916
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NJ  26NR09130100)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: NJ  26nj00285700)
Enumeration Date2010-02-15
Last Update Date2019-01-24
Business Address
LISA WYDRA
3391 HIGHWAY 35
HAZLET, NJ 07730-1521
Phone number: 732-888-8299
Mailing Address
LISA WYDRA
3391 HIGHWAY 35
HAZLET, NJ 07730-1521
Phone number: 732-888-8299