Provider Demographics
NPI:1124244454
Name:MUNOZ, LISA MULLER (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MULLER
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:MULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:188 MORRISTOWN RD
Mailing Address - Street 2:ROUTE 202
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1651
Mailing Address - Country:US
Mailing Address - Phone:908-221-0400
Mailing Address - Fax:908-221-9446
Practice Address - Street 1:188 MORRISTOWN RD
Practice Address - Street 2:ROUTE 202
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1651
Practice Address - Country:US
Practice Address - Phone:908-221-0400
Practice Address - Fax:908-221-9446
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00426500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ876526TD3Medicare ID - Type UnspecifiedRENDERING PHYSICIAN ID