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General NPI Number Information
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NPI Number | 1588420996
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Entity Type | Individual
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Provider Name | LISA DORIS LE,MTH
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Gender | Female
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Dates
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Enumeration Date | 02/23/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 26110 TOWN GREEN DR
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City | ELMSFORD
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State | NY
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Zip | 10523-1586
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Country | US
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Telephone | 914-848-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 26110 TOWN GREEN DR
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City | ELMSFORD
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State | NY
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Zip | 10523-1586
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Country | US
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Telephone |
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Fax |
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | 28D0107
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License Number State | NY
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