Individual
MISS LISA FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5072
Mailing address
550 1ST AVENUE, NEW YORK, NY 10016
(212) 263-5072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR16652300
NJ
163W00000X
Registered Nurse
588891-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
367500000X
NY
367500000X
Certified Registered Nurse Anesthetist
588891-1
NY
Other
Enumeration date
11/04/2015
Last updated
09/13/2022
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