Individual
MS. DENISE A LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1205 TROY SCHENECTADY RD STE 101, LATHAM, NY 12110-1074
(518) 348-3176
Mailing address
7 PEBBLE BEACH DR, CLIFTON PARK, NY 12065-1106
(518) 369-7493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005033
NY
363AM0700X
Medical Physician Assistant
005033
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005033
LICENSE
NY
Enumeration date
11/06/2006
Last updated
02/14/2025
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