Individual
MS. LISA JEAN MAMAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
147 BEACH RD STE A, WESTHAMPTON BEACH, NY 11978
(631) 288-7746
(631) 288-7111
Mailing address
147 BEACH RD STE A, WESTHAMPTON BEACH, NY 11978-1733
(631) 288-7746
(631) 288-7111
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
282828
NY
Other
Enumeration date
07/13/2011
Last updated
09/10/2018
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