Most Relevant Information
Provider Data
| NPI Number: | 1003826157 |
| Provider Name: | LISA M MICIK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 010318 |
Most Important Dates
| Enumeration Date: | 08/09/2006 |
| Last Updated: | 06/17/2014 |
Provider Practice Location
1 W RIDGEWOOD AVE
SUITE 103
PARAMUS
NJ
076522359
Practice Location Phone/Fax
| Phone: | 2018574200 |
| Fax: | 2018574199 |
Provider Mailing Location
1 W RIDGEWOOD AVE STE 103
PARAMUS
NJ
076522361
Provider Mailing Phone/Fax
| Phone: | 2018574200 |
| Fax: |