Healthcare Provider Details

I. General information

NPI: 1306819404
Provider Name (Legal Business Name): DR. LISA R SAIMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY COLUMBIA UNIVERSITY DEPARTMT PEDIATRICS
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

11 RAVINE DR
HASTINGS ON HUDSON NY
10706-1209
US

V. Phone/Fax

Practice location:
  • Phone: 212-304-7250
  • Fax: 212-544-1974
Mailing address:
  • Phone: 212-305-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number163034
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: