Individual
DR. LISON GAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
198 EAST 121ST STREET, NEW YORK, NY 10035
(202) 803-2719
Mailing address
198 EAST 121ST STREET, NEW YORK, NY 10035
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
266302
NY
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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