Healthcare Provider Details

I. General information

NPI: 1508061243
Provider Name (Legal Business Name): LISA VI DOAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST 14TH FLOOR
NEW YORK NY
10016-2708
US

IV. Provider business mailing address

240 E 38TH ST 14TH FLOOR
NEW YORK NY
10016-2708
US

V. Phone/Fax

Practice location:
  • Phone: 212-201-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number245749
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number245749
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: