Chana Devora Lisser, PA-C
Physician Assistant in Flushing, NY. Individual provider (NPI-1).
NPI number1982249959
StatusActive
Last updated in NPPESApr 8, 2025
Details
- NPI
- 1982249959
- Entity type
- Individual (NPI-1)
- Name
- Chana Devora Lisser
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 13, 2019
- Certification date
- Apr 8, 2025
- Last updated
- Apr 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 024523 | NY | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
14449 72nd RdFlushing, NY 11367-2405
Phone 301-908-3388
Mailing address
643 Hicksville RdFar Rockaway, NY 11691-5220
Phone 301-908-3388
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