Individual
DR. MICHELE LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, 3RD FLOOR RADIOLOGY, SYRACUSE, NY 13210-2306
(315) 464-6672
Mailing address
224 HARRISON ST, SUITE 601, SYRACUSE, NY 13202-3056
(315) 464-6672
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
227703
NY
2085R0202X
Diagnostic Radiology Physician
Primary
2277031
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02224500
—
NY
05
—
02375079
—
NY
Enumeration date
08/19/2005
Last updated
03/17/2008
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