Individual
LISA S. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 627-6624
(516) 627-3804
Mailing address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 627-6624
(516) 627-3804
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
209718
NY
207L00000X
Anesthesiology Physician
Primary
209718-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01821732
—
NY
Enumeration date
06/24/2005
Last updated
08/24/2010
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