Individual
DR. NEAL M. LISANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9520 63RD RD STE H, REGO PARK, NY 11374-1145
(718) 755-0656
(866) 310-5525
Mailing address
9520 63RD RD STE H, REGO PARK, NY 11374-1145
(718) 755-0656
(866) 310-5525
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
151666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00932009
—
NY
Enumeration date
03/22/2006
Last updated
01/25/2019
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