Healthcare Provider Details

I. General information

NPI: 1306974258
Provider Name (Legal Business Name): LISA M. DEL POZO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S FRANKLIN ST SUITE A
HEMPSTEAD NY
11550-7336
US

IV. Provider business mailing address

421 S FRANKLIN ST SUITE A
HEMPSTEAD NY
11550-7336
US

V. Phone/Fax

Practice location:
  • Phone: 516-280-5558
  • Fax: 866-278-1987
Mailing address:
  • Phone: 516-280-5558
  • Fax: 866-278-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333926
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: