Tannenbaum, Lisa Michelle

Tannenbaum, Lisa Michelle is an individual health care provider with primary practice located at 100 Granny Rd Unit 2 , Farmingville NY 11738-2879. 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. Tannenbaum, Lisa Michelle can be contacted via phone (631) 696-4357.

Contact Information

Primary practice address
100 Granny Rd Unit 2 Farmingville NY 11738-2879
Phone: (631) 696-4357
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1164958 New York

Profile Details

NPI number 1114578507
LBN Legal business name Tannenbaum, Lisa Michelle
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2019
Last updated Sep 26th, 2019 - about 6 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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