Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 252268 | NY |
N | 207P00000X | Emergency Physician | 252268 | NY |
N | 207R00000X | Internist | 252268 | NY |
N | 111NI0900X | Internist | 252268 | NY |
NPI | 1194843292 |
---|---|
Provider Name | Dr. Lisa Meredith Preston |
First Address | New York, NY 10001-0000 |
Second Address | New York, NY 10001-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 12/07/2013 |