Doctor Name: | LARISSA LOBATO |
NPI Number: | 1023367166 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 26NJ00391900 |
Business Practice Address: | 11 Bishop Pl New Brunswick, NJ - 089011178 |
Business Phone Number: | 7329327402 |
Business Fax Number: | |
Mailing Address: | 11 Bishop Pl, NEW BRUNSWICK |
State: | NJ |
Postal Code: | 089011178 |
Phone Number: | 7329327402 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2012 |
NPI Last Update Date: | 09/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00391900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |