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Individual

MS. LISA MARIE CANTARA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS, ATC, CSCS

Contact information

Practice address
100 NICOLLS RD, SBU, ISC, STONY BROOK, NY 11794-3500
(631) 632-7709
Mailing address
460 OLD TOWN RD, 24F, PORT JEFFERSON STATION, NY 11776-2200
(631) 474-4908
(631) 632-3231

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
297-1
NY

Other

Enumeration date
04/11/2006
Last updated
07/08/2007
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