Individual
DR. LISA ANN FORESTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
444 COMMUNITY DR., SUITE # 306, MANHASSET, NY 11030
(516) 512-1574
Mailing address
600 PINE HOLLOW RD., # 20-4A, EAST NORWICH, NY 11732
(516) 512-1574
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016851
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
12/20/2006
Last updated
07/08/2007
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