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General NPI Number Information
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NPI Number | 1184906968
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Entity Type | Individual
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Provider Name | LISA SALANDRA-BIRNBAUM NP-C, APN-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 350 ENGLE ST EHMC
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City | ENGLEWOOD
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State | NJ
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Zip | 07631
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Country | US
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Telephone | 877-273-2782
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Fax |
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Provider Business Mailing Address
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Address Line | 99 ROSE AVE
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677
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Country | US
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Telephone | 201-925-0123
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Fax | 201-307-1016
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00328800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F305661-1
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License Number State | NY
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