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Individual

LISA MARSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
30 S CAYUGA RD, WILLIAMSVILLE, NY 14221-6728
(716) 632-1088
Mailing address
30 S CAYUGA RD, WILLIAMSVILLE, NY 14221-6728
(716) 632-1088

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
566373
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
566373
NEW YORK STATE
NY
Enumeration date
04/24/2015
Last updated
11/02/2016
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