Individual
KRISTINE M LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
762 LINDLEY ST, BRIDGEPORT, CT 06606-5046
(203) 576-5440
(203) 581-6509
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-5440
(203) 581-6509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042871
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001428714
—
CT
05
—
004187812
—
CT
Enumeration date
07/12/2006
Last updated
04/03/2014
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