Provider Demographics
NPI:1073274049
Name:SCARLATELLA, LISA (ARNP, PMHNP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:SCARLATELLA
Suffix:
Gender:F
Credentials:ARNP, PMHNP
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SCARLATELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:285 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1006
Mailing Address - Country:US
Mailing Address - Phone:973-443-8535
Mailing Address - Fax:973-443-8174
Practice Address - Street 1:274 MADISON AVE RM 1501
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0701
Practice Address - Country:US
Practice Address - Phone:212-203-1773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ012453002084P0800X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology