Healthcare Provider Details

I. General information

NPI: 1124030069
Provider Name (Legal Business Name): LISA ANN STRAUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 ROUTE 343 HUDSON RIVER HEALTHCARE, INC.
AMENIA NY
12501-5619
US

IV. Provider business mailing address

1037 MAIN ST CREDENTIALING DEPT
PEEKSKILL NY
10566-2913
US

V. Phone/Fax

Practice location:
  • Phone: 845-373-9006
  • Fax: 845-373-7021
Mailing address:
  • Phone: 914-734-8858
  • Fax: 914-734-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number181394
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: