Provider Demographics
NPI:1265401699
Name:BARISCIANO, LISA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BARISCIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 JAMES STREET
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:09732-1346
Mailing Address - Country:US
Mailing Address - Phone:973-503-0600
Mailing Address - Fax:973-503-0424
Practice Address - Street 1:15 JAMES STREET
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:09732-1346
Practice Address - Country:US
Practice Address - Phone:973-503-0600
Practice Address - Fax:973-503-0424
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA075732207K00000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBEECH STREETOther21247588446
NJ0009335992OtherPHCS
NJ7736574OtherAETNA
NJP3238057OtherOXFORD
NJ2K6693OtherHEALTHNET
NJCIGNAOther4786617
NJ7736574OtherAETNA