Provider Demographics
NPI:1346430709
Name:NAKASHIAN, LISA M (PA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:NAKASHIAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1001 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3119
Mailing Address - Country:US
Mailing Address - Phone:732-539-3973
Mailing Address - Fax:877-912-5770
Practice Address - Street 1:1 BARNARD LN
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2481
Practice Address - Country:US
Practice Address - Phone:860-761-6666
Practice Address - Fax:860-761-2502
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2015-07-10
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Provider Licenses
StateLicense IDTaxonomies
CT002108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant