Individual
LISA DISHONGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
190 W BROAD ST, STE G401 WHITTINGHAM PAVILION, STAMFORD, CT 06902-3633
(203) 325-4321
(203) 975-7515
Mailing address
190 W BROAD ST, STE G401 WHITTINGHAM PAVILION, STAMFORD, CT 06902-3633
(203) 325-4321
(203) 975-7515
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
030488
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010030488CT01
BCCT
—
01
—
061483728
CGNA
—
01
—
06148372804
POMC
—
01
—
061483728046
ONE
—
01
—
0V5983
HNET
—
01
—
1013349
ATNA
—
01
—
160001569
MCR
—
01
—
ZP196
OHP
—
Enumeration date
09/11/2006
Last updated
10/27/2011
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