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Individual

DR. LISA A CAVANAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 EXPRESSWAY PLAZA, SUITE 115, ROSLYN HEIGHTS, NY 11577
(516) 759-1131
(516) 676-5727
Mailing address
1 EXPRESSWAY PLAZA, SUITE 115, ROSLYN HEIGHTS, NY 11577
(516) 759-1131
(516) 676-5727

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
201939
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01841478
NY
Enumeration date
06/08/2006
Last updated
02/13/2019
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