Provider Demographics
NPI:1912999749
Name:TUFANKJIAN, LISA G (DO)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:G
Last Name:TUFANKJIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMILTON HEALTH PL
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3542
Mailing Address - Country:US
Mailing Address - Phone:609-631-6899
Mailing Address - Fax:609-631-6898
Practice Address - Street 1:1 HAMILTON HEALTH PL
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3542
Practice Address - Country:US
Practice Address - Phone:609-631-6899
Practice Address - Fax:609-631-6898
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB74511207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2133945000OtherAMERIHEALTH
NJ2391807OtherCIGNA HEALTHCARE
NJ2112037OtherUNITED HEALTHCARE
NJ8275203Medicaid
NJ60001815OtherHORIZON NJ HEALTH
NJ2K1877OtherHEALTHNET
NJ7536248OtherAETNA USHC
NJP2696618OtherOXFORD HEALTHPLAN
NJ01000462804OtherAMERICHOICE
NJ312637OtherUS FAMILY HEALTHPLAN
NJ35510OtherUNIVERSITY HEALTHPLAN
NJ89178OtherAMERIGROUP
NJ2K1877OtherHEALTHNET
NJP2696618OtherOXFORD HEALTHPLAN