Individual
LISA M TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7 SEAFIELD LN, WESTHAMPTON BEACH, NY 11978-2714
(631) 288-1122
Mailing address
35 E LAKE TER, LAKE RONKONKOMA, NY 11779-2708
(631) 229-5982
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
842746-01
NY
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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