Provider Demographics
NPI:1699317834
Name:HOBERMAN, LISA E (RN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:E
Last Name:HOBERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 2ND AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7406
Mailing Address - Country:US
Mailing Address - Phone:212-360-7875
Mailing Address - Fax:212-937-0928
Practice Address - Street 1:1900 2ND AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7406
Practice Address - Country:US
Practice Address - Phone:212-360-7875
Practice Address - Fax:212-937-0928
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY485673-1163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)