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Individual

LISA CAROLINE PREDMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
1165 NORTHERN BLVD, SUITE 302, MANHASSET, NY 11030-3048
(516) 627-7600
(516) 627-6378
Mailing address
1165 NORTHERN BLVD, SUITE 302, MANHASSET, NY 11030-3048
(516) 627-7600
(516) 627-6378

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
001204
NY
332S00000X
Hearing Aid Equipment
001204
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02266580
NY
Enumeration date
01/17/2006
Last updated
07/15/2015
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