Dr. Anthony Vincent Lisa, MD
Student in an Organized Health Care Education/Training Program in Stony Brook, NY. Individual provider (NPI-1).
NPI number1982307724
StatusActive
Last updated in NPPESJun 29, 2024
Details
- NPI
- 1982307724
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anthony Vincent Lisa
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2023
- Certification date
- Jun 29, 2024
- Last updated
- Jun 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
101 Nicholls RoadStony Brook, NY 11794-8460
Phone 631-444-2484 · Fax 631-444-7538
Mailing address
101 Nicholls RoadStony Brook, NY 11794-8460
Phone 631-444-2484 · Fax 631-444-7538
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All 848 Student in an Organized Health Care Education/Training Program providers in Stony Brook · All 3,268 providers in Stony Brook
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