Bardack, Lisa R
Bardack, Lisa R is an individual health care provider with primary practice located at 90 S Bedford Rd Care Mount Medical Pc, Mount Kisco NY 10549-3412. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Bardack, Lisa R can be contacted via phone (914) 241-1050.Contact Information
Primary practice address
90 S Bedford Rd Care Mount Medical Pc
Mount Kisco NY 10549-3412
Phone: (914) 241-1050
Fax: (914) 242-1516
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 187980 | New York |
Profile Details
| NPI number | 1669421053 |
|---|---|
| LBN Legal business name | Bardack, Lisa R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2006 |
| Last updated | Nov 11th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669421053 | NPPES |
| New York | MEDICAID | 01435758 | |
| New York | Other | 0667910001 | |
| New York | Other | 110153364 |
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