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General NPI Number Information
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NPI Number | 1124283825
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Entity Type | Individual
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Provider Name | DR. LIONEL BISSOON
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Gender | Male
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 10 W 74TH ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10023-2403
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Country | US
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Telephone | 212-579-9136
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Fax | 212-579-6917
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Provider Business Mailing Address
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Address Line | 10 W 74TH ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10023-2403
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Country | US
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Telephone | 212-579-9136
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Fax | 212-579-6917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 193423
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 20A8115
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | OS 8296
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License Number State | FL
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