Individual
LISA R FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519-1369
(203) 785-2140
(203) 785-6414
Mailing address
300 GEORGE ST, PO BOX 9805, NEW HAVEN, CT 06511-6624
(203) 785-7998
Taxonomy
Speciality
Code
Description
License number
State
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
001679
CT
363A00000X
Physician Assistant
Primary
001679
CT
Other
Enumeration date
04/06/2006
Last updated
08/27/2021
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