Provider Demographics
NPI:1609208511
Name:MARMO, LIZA M (APN)
Entity Type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:M
Last Name:MARMO
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Gender:F
Credentials:APN
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Mailing Address - Street 1:105 RAIDER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1528
Mailing Address - Country:US
Mailing Address - Phone:908-281-0221
Mailing Address - Fax:908-281-0940
Practice Address - Street 1:105 RAIDER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1528
Practice Address - Country:US
Practice Address - Phone:908-281-0221
Practice Address - Fax:908-281-0940
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2016-11-17
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Provider Licenses
StateLicense IDTaxonomies
PAS013011363LA2200X
NJ26NJ00464100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health