Provider Demographics
NPI:1245292838
Name:SAEZ, LISA A (PT)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:A
Last Name:SAEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2006
Mailing Address - Country:US
Mailing Address - Phone:732-255-1264
Mailing Address - Fax:
Practice Address - Street 1:1985 HIGHWAY 34
Practice Address - Street 2:UNIT A5
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719-9100
Practice Address - Country:US
Practice Address - Phone:732-282-9228
Practice Address - Fax:732-282-9227
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA03408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ847705PH8Medicare ID - Type Unspecified