Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 12742 | NH |
NPI | 1063440063 |
---|---|
Provider Name | Dr. Lisa Anne Furmanski |
First Address | Lebanon, NH 03766-2900 |
Second Address | Lebanon, NH 03766-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011670 | (05) | VT |
30205223 | (05) | NH |
H03512 | (02) |