Provider Demographics
NPI:1083886147
Name:KATZ BUGLINO, LISA (DO)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:KATZ BUGLINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2800 MARCUS AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-608-2898
Mailing Address - Fax:516-608-2897
Practice Address - Street 1:2800 MARCUS AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-608-6898
Practice Address - Fax:516-608-2897
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245549207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics