Lissauer, Boaz J
Lissauer, Boaz J is an sole proprietor health care provider with primary practice located at 1036 Park Ave Suite 1C, New York NY 10028-0971. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Lissauer, Boaz J can be contacted via phone (212) 717-2150.Contact Information
Primary practice address
1036 Park Ave Suite 1C
New York NY 10028-0971
Phone: (212) 717-2150
Fax: (212) 717-2154
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 208452 | New York |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 25MA07699200 | New Jersey |
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 25MA07699200 | New Jersey |
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 208452 | New York |
Profile Details
| NPI number | 1639173123 |
|---|---|
| LBN Legal business name | Lissauer, Boaz J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Jun 25th, 2009 - about 16 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 | 1639173123 | NPPES |
| New York | Other | BL0482B310 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | 7554155 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | BL0482B310 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | P2647045 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | 0498250 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | 1000035875 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | 208452 | FEDERAL BLUE CROSS BLUE S |
| New York | Other | 271252B | FEDERAL BLUE CROSS BLUE S |
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