Healthcare Provider Details

I. General information

NPI: 1043657430
Provider Name (Legal Business Name): LISA M GREENFIELD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA M DANOWSKI

II. Dates (important events)

Enumeration Date: 05/27/2013
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST
RENO NV
89502
US

IV. Provider business mailing address

PO BOX 11276
RENO NV
89510-1276
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-4144
  • Fax:
Mailing address:
  • Phone: 775-324-4040
  • Fax: 775-324-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number17417
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17417
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: