Individual
MRS. LISA A BAUSERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
3815 CLARK STREET, SEAFORD, NY 11783-5048
(516) 524-7119
Mailing address
3815 CLARK ST., SEAFORD, NY 11783-5048
(516) 524-7119
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307981-1
NY
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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