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Individual

ALISHA MARIE LAUTSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
297 TOWN LINE RD, EAST NORTHPORT, NY 11731-5502
(631) 223-6636
Mailing address
297 TOWN LINE RD, EAST NORTHPORT, NY 11731-5502
(631) 223-6636

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
07/06/2021
Last updated
07/06/2021
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