Provider Demographics
NPI:1588933717
Name:PERLMUTTER, LISA (ARNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PERLMUTTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 BLOOMFIELD AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7585
Mailing Address - Country:US
Mailing Address - Phone:973-226-4439
Mailing Address - Fax:973-226-4452
Practice Address - Street 1:616 BLOOMFIELD AVE STE 1A
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7585
Practice Address - Country:US
Practice Address - Phone:973-226-4439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9332460363LP0200X
NJ26NJ00603700363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics