Provider Demographics
NPI:1427278845
Name:HUNTER ROMANELLI, LISA (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HUNTER ROMANELLI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE C-9
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-759-5882
Mailing Address - Fax:609-759-5882
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE C-9
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-759-5882
Practice Address - Fax:609-759-5882
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014094103TB0200X
NJ35SI00476100103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV588D1Medicare ID - Type Unspecified
NYP2607202OtherOXFORD PROVIDER ID