Provider Demographics
NPI:1124555685
Name:FEIFERT, LISA MICHELLE (HIS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:FEIFERT
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:DEBENEDICTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIS
Mailing Address - Street 1:1050 KINGS HWY N STE 101
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1909
Mailing Address - Country:US
Mailing Address - Phone:856-438-5354
Mailing Address - Fax:856-435-5691
Practice Address - Street 1:1050 KINGS HWY N STE 101
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1909
Practice Address - Country:US
Practice Address - Phone:856-438-5354
Practice Address - Fax:856-435-5691
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG001434237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist