Individual
LISA SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA
Contact information
Practice address
1367 WASHINGTON AVE, SUITE 200, ALBANY, NY 12206-1043
(518) 489-2666
(518) 489-5933
Mailing address
1367 WASHINGTON AVE, SUITE 200, ALBANY, NY 12206-1043
(518) 489-2666
(518) 489-5933
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000471292001
BS NENY
NY
01
—
318824
MVP
NY
Enumeration date
10/12/2006
Last updated
02/25/2008
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