MS. Lisa Michelle Tannenbaum, PA-C
NPI #1114578507 in Farmingville, New York
Provider Information
- NPI Number
- 1114578507
- Entity Type
- Individual
- Name
- MS. Lisa Michelle Tannenbaum, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Sep 26, 2019
- Last Updated
- Sep 26, 2019
Practice Location
- Address
- 100 GRANNY RD UNIT 2
- City
- Farmingville
- State
- New York
- ZIP Code
- 11738-2879
- Phone
- (631) 696-4357
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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