Individual
LIANNE DESERRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19 BRADHURST AVE STE 3600S, HAWTHORNE, NY 10532-2140
(914) 693-7636
Mailing address
19 BRADHURST AVE STE 3100N, HAWTHORNE, NY 10532-2140
(914) 909-9018
(914) 909-9028
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
212745
NY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
212745
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932723
—
NY
Enumeration date
08/21/2006
Last updated
02/23/2021
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