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NPI Code Detail

MEDICARE: MRS. ESTHER LISSAUER MS

MEDICARE: MRS. ESTHER LISSAUER MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst15BC00107800NJ

General Provider Information

NPI Number : 1053668178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ESTHER LISSAUER MS
Provider Business Mailing Address
First Line : 1166 RIVER AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5677
Country : US
Telephone Number : 732-965-6444
Fax Number :
Provider Business Practice Location Address
First Line : 1166 RIVER AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5677
Country : US
Telephone Number : 732-965-6444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2012
Last Update Date : 04/01/2025

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Directions to “ MRS. ESTHER LISSAUER MS” Practice Location

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