Individual
CARISSA M LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
35 GILBERT STREET, CAMBRIDGE MEDICAL CENTER, CAMBRIDGE, NY 12816-2618
(518) 677-3961
(518) 677-3180
Mailing address
100 PARK STREET, GLENS FALLS HOSPITAL - CREDENTIALING, GLENS FALLS, NY 12801-4413
(518) 926-5924
(518) 926-6983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
332725
NY
Other
Enumeration date
05/14/2021
Last updated
09/24/2024
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