Provider Demographics
NPI:1477822450
Name:MIRAGLIA-RANOFF, LISA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:MIRAGLIA-RANOFF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1706
Mailing Address - Country:US
Mailing Address - Phone:201-444-4190
Mailing Address - Fax:
Practice Address - Street 1:191 ROCK RD
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1706
Practice Address - Country:US
Practice Address - Phone:201-444-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01994900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist