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Individual
DR. BOAZ J LISSAUER
Active
Individual
DR. BOAZ J LISSAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
208452
NY
207W00000X
Ophthalmology Physician
25MA07699200
NJ
2086S0122X
Plastic and Reconstructive Surgery Physician
208452
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
25MA07699200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0498250
GHI
NY
01
—
1000035875
AFFNITY HEALTH PLAN
NY
01
—
208452
HIP
NY
01
—
271252B
DIVISION 1181 MAGNACARE
NY
01
—
7554155
AETNA
—
01
—
BL0482B310
BLUE CROSS BLUE SHIELD
NY
01
—
P2647045
OXFORD
—
Enumeration date
06/13/2005
Last updated
06/25/2009
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