Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 042-0014664 | VT |
N | 207Q00000X | Family Doctor | 269426 | NY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 042-0014664 | VT |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 269426 | NY |
NPI | 1255575379 |
---|---|
Provider Name | Lisa J Downing-Forget |
First Address | Rochester, NY 14626-5107 |
Second Address | Bennington, VT 05201-5010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2009 |
Last Update Date | 28/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03586032 | (05) | NY |