Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 162448-1 | NY |
NPI | 1568425767 |
---|---|
Provider Name | Lisa L. Anderson |
First Address | New York, NY 10087-8082 |
Second Address | New York, NY 10019-8022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 16/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00994289 | (05) | NY |
A64720 | (02) |