Individual
DR. ANTHONY VINCENT LISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICHOLLS ROAD, STONY BROOK, NY 11794-8460
(631) 444-2484
(631) 444-7538
Mailing address
101 NICHOLLS ROAD, STONY BROOK, NY 11794-8460
(631) 444-2484
(631) 444-7538
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
06/29/2024
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