Individual
LISA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5822 BROADWAY, BRONX, NY 10463-2454
(718) 549-3185
Mailing address
5822 BROADWAY, BRONX, NY 10463-2454
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310016
NY
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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