Individual
MRS. LISA MICHELE DEFUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4901 VETERANS BLVD., METAIRIE, LA 70001
(504) 887-1133
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.026056
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09876251
—
MS
05
—
1050962
—
LA
Enumeration date
09/14/2006
Last updated
11/20/2007
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