Individual
LISA R STATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
441 STUART ST, #404, BOSTON, MA 02116-5019
(857) 317-2057
Mailing address
441 STUART ST, #404, BOSTON, MA 02116-5019
(857) 317-2057
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
5985
MA
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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