Individual
LISA HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2000
Mailing address
575 LEXINGTON AVENUE, NEW YORK, NY 10065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
408230
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
408230
NY
Other
Enumeration date
10/05/2007
Last updated
12/19/2024
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