MEDICARE: DR. LISA KAREN HOCHBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	155438-1	NY

General Provider Information

NPI Number	:	1104098763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA KAREN HOCHBERG MD

Provider Business Mailing Address
First Line	:	253 CLINTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6146
Country	:	US
Telephone Number	:	718-596-1606
Fax Number	:	718-596-1683

Provider Business Practice Location Address
First Line	:	253 CLINTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6146
Country	:	US
Telephone Number	:	718-596-1606
Fax Number	:	718-596-1683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2008
Last Update Date	:	03/24/2008

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