Provider Demographics
NPI:1790019230
Name:SANDHUSEN, LISA MARIE
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:SANDHUSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 HARRIS PL
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1203
Mailing Address - Country:US
Mailing Address - Phone:201-483-3399
Mailing Address - Fax:
Practice Address - Street 1:323 HARRIS PL
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-1203
Practice Address - Country:US
Practice Address - Phone:201-483-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula