Provider Demographics
NPI:1891218020
Name:CHEIFETZ, LISANNE
Entity Type:Individual
Prefix:
First Name:LISANNE
Middle Name:
Last Name:CHEIFETZ
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 1:267 MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3060
Mailing Address - Country:US
Mailing Address - Phone:201-841-0842
Mailing Address - Fax:
Practice Address - Street 1:267 MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3060
Practice Address - Country:US
Practice Address - Phone:201-841-0842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics