Individual
LISA J. HERZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
22 BOSHER DR, ALBANY, NY 12205-1702
(518) 482-3280
(518) 482-3280
Mailing address
22 BOSHER DR, ALBANY, NY 12205-1702
(518) 482-3280
(518) 482-3280
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
0146841
NY
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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