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General NPI Number Information
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NPI Number | 1619973294
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Entity Type | Individual
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Provider Name | LISA E CONNERY MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 75 BEEKMAN STREET
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City | PLATTSBURG
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State | NY
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Zip | 12901-1438
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Country | US
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Telephone | 518-561-2000
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Fax | 518-562-7542
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Provider Business Mailing Address
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Address Line | 75 BEEKMAN STREET
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City | PLATTSBURG
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State | NY
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Zip | 12901-1438
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Country | US
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Telephone | 518-561-2000
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Fax | 518-562-7542
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA07981200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 189380
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G63224
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME94486
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License Number State | FL
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