Individual
LORI ANN ATTIVISSIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., F.A.C.P.
Contact information
Practice address
99 SUNNYSIDE BLVD, WOODBURY, NY 11797-2901
(516) 832-7100
Mailing address
53 CHESTNUT LN, WOODBURY, NY 11797-1918
(516) 353-4790
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
186961
NY
207RH0003X
Hematology & Oncology Physician
186961
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01635712
—
NY
Enumeration date
10/27/2006
Last updated
10/06/2014
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