Provider Demographics
NPI:1437373727
Name:KOSTER, LISA (PA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KOSTER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1820 CORLIES AVENUE
Mailing Address - Street 2:SUITE4B
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-776-8500
Mailing Address - Fax:732-988-2347
Practice Address - Street 1:1820 CORLIES AVENUE
Practice Address - Street 2:SUITE4B
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-776-8500
Practice Address - Fax:732-988-2347
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00157200363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical