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General NPI Number Information
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NPI Number | 1023153046
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Entity Type | Individual
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Provider Name | LISA MARIE CORDUAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 WOODBRIDGE CTR SUITE 245
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1150
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Country | US
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Telephone | 732-855-8522
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Fax | 732-634-7920
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Provider Business Mailing Address
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Address Line | 39 NEWLAND CT
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1446
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Country | US
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Telephone | 908-707-1517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MC3135
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License Number State | NJ
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