Individual
MRS. LISA MARIA CHRISTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA,SI
Contact information
Practice address
207 STORM DR, HOLTSVILLE, NY 11742-1921
(631) 235-8962
Mailing address
207 STORM DR, HOLTSVILLE, NY 11742-1921
(631) 235-8962
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1914670
NY
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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