Individual
LISA JOY UNDERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
111 EAST 210TH ST, BRONX, NY 10467
(800) 636-6683
Mailing address
3411 WAYNE AVE, BRONX, NY 10467-2509
(832) 867-4580
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP10037148
TX
2080P0205X
Pediatric Endocrinology Physician
Primary
60 283152
NY
2080P0205X
Pediatric Endocrinology Physician
P6292
TX
Other
Enumeration date
05/11/2010
Last updated
06/27/2016
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