Individual
DR. ANNA LIZZA LOPEZ SIASOCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
415 PORT WASHINGTON BLVD, PORT WASHINGTON, NY 11050-4201
(516) 883-0218
(516) 767-0894
Mailing address
415 PORT WASHINGTON BLVD, PORT WASHINGTON, NY 11050-4201
(516) 883-0218
(516) 767-0894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
236459
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3363P1
EMPIRE BLUECROSS BLUESHIE
NY
01
—
5880458
CIGNA
NY
01
—
5995775
GHI
NY
01
—
5C5341
HEALTH NET OF NORTHEAST
NY
01
—
9412517
PHCS
NY
01
—
SA6459
ATLANTIS
NY
Enumeration date
01/23/2006
Last updated
09/12/2014
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