Individual
LISA SARA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
505 E 70TH ST, 2ND FLR., NEW YORK, NY 10021-4872
(212) 249-1578
(212) 746-8483
Mailing address
504-506 EAST 74TH STREET, 5TH FLOOR, NEW YORK, NY 10021
(212) 249-4061
(212) 249-4659
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00302632
—
NY
Enumeration date
07/18/2006
Last updated
07/09/2007
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