Brusca, Lisa M

Brusca, Lisa M is an individual health care provider with primary practice located at 975 Stewart Ave , Garden City NY 11530-4816. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Brusca, Lisa M can be contacted via phone (516) 222-8600.

Contact Information

Primary practice address
975 Stewart Ave Garden City NY 11530-4816
Phone: (516) 222-8600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 010935 New York

Profile Details

NPI number 1528048246
LBN Legal business name Brusca, Lisa M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Jan 4th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528048246 NPPES
New York Other 010935 NYS LICENSE

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