Individual
MS. LISA ROMARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP.
Contact information
Practice address
STONY BROOK CHILDRENS HOSPITAL, T-11, RM 080, STONY BROOK, NY 11794-8111
(631) 444-8340
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-8111
(631) 444-8340
(631) 444-6045
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02049907
—
NY
01
—
93N781
EMPIRE BC.BS
NY
Enumeration date
06/14/2006
Last updated
07/28/2017
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