Dr. Joan Wanda Lisak
Internist - Cardiovascular Disease
780 Chestnut St Suite 20
Springfield
, Massachusetts 01107-1610
Dr. Joan Wanda Lisak
Internist - Cardiovascular Disease
780 Chestnut St Suite 20
Springfield
, Massachusetts 01107-1610
(413) 781-2202
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Dr. Joan Wanda Lisak
- Po Box 2041
- Springfield, MA
- Zip : 01101-2041
- Fax : (413) 781-2202
- Phone : (413) 781-2200
Second Address
- Dr. Joan Wanda Lisak
- 780 Chestnut St Suite 20
- Springfield, MA
- Zip : 01107-1610
- Fax : (413) 781-2202
- Phone : (413) 781-2200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | 57480 | MA |
National Provider Identifier
| NPI | 1013942531 |
|---|---|
| Provider Name | Dr. Joan Wanda Lisak |
| First Address | Springfield, MA 01101-2041 |
| Second Address | Springfield, MA 01107-1610 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/07/2006 |
| Last Update Date | 15/12/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3089428 | (05) | MA |
| F18684 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.