Provider Demographics
NPI:1306816541
Name:FINNEGAN, LISA A (ANP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CHESTNUT STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-447-3866
Mailing Address - Fax:201-562-1332
Practice Address - Street 1:140 CHESTNUT STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-447-3866
Practice Address - Fax:201-652-1332
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ038106921363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner