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General NPI Number Information
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NPI Number | 1578219622
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Entity Type | Individual
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Provider Name | LISANNE FLOTO HANRAHAN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 1000 WHITE HORSE RD STE 806
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City | VOORHEES
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State | NJ
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Zip | 08043-4414
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Country | US
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Telephone | 609-330-3574
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Fax |
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Provider Business Mailing Address
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Address Line | 344 AVONDALE AVE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2639
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Country | US
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Telephone | 609-330-3574
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NJ
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