Provider Demographics
NPI:1295032308
Name:ABATANGELO, LISA ANN (APN - C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:ABATANGELO
Suffix:
Gender:F
Credentials:APN - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2211
Mailing Address - Country:US
Mailing Address - Phone:732-792-3954
Mailing Address - Fax:
Practice Address - Street 1:8 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2211
Practice Address - Country:US
Practice Address - Phone:732-792-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00320800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily