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General NPI Number Information
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NPI Number | 1619336674
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Entity Type | Individual
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Provider Name | LISA MARIE SAUER AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 9741 STATE ROUTE 97
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City | CALLICOON
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State | NY
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Zip | 12723-5447
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Country | US
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Telephone | 845-887-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 79 COUNTY ROAD 114
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City | COCHECTON
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State | NY
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Zip | 12726-5216
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Country | US
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Telephone | 845-807-2297
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F340740-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 307630
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License Number State | NY
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