Individual
EMILY LISANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 GRANDVIEW ST, HUNTINGTON, NY 11743-3534
(631) 786-1242
Mailing address
17 GRANDVIEW ST, HUNTINGTON, NY 11743-3534
(631) 786-1242
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025011
NY
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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