Basic Information
| Provider Information | |||||||||
| NPI: | 1710091731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHILLING | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HARVEST LANE | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099538725 | ||||||||
| FaxNumber: | 6092063015 | ||||||||
| Practice Location | |||||||||
| Address1: | 560 STOKES RD | ||||||||
| Address2: | HEARTLAND REHABILITATION SERVICES OF NEW JERSEY INC | ||||||||
| City: | MEDFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6097147960 | ||||||||
| FaxNumber: | 6097147961 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA00235400 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.