Healthcare Provider Details

I. General information

NPI: 1447252390
Provider Name (Legal Business Name): MITSI H. LIZER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 N SECTOR CT
WINCHESTER VA
22601-2859
US

IV. Provider business mailing address

220 RED OAK RD
CROSS JUNCTION VA
22625-2269
US

V. Phone/Fax

Practice location:
  • Phone: 540-545-7316
  • Fax:
Mailing address:
  • Phone: 540-888-3836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number0202009207
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: