Individual
DR. LISA MALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
123 LAUREL LN, LAWRENCE, NY 11559-1421
(516) 371-2523
Mailing address
123 LAUREL LN, LAWRENCE, NY 11559-1421
(516) 371-2523
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002409
CT
152W00000X
Optometrist
27OA00576200
NJ
152W00000X
Optometrist
Primary
T005589
NY
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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