Provider Demographics
NPI:1154188613
Name:ASMAR, LISA OGARET
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:OGARET
Last Name:ASMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:OGARET
Other - Last Name:ASMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ASMAR-ABDIEN
Mailing Address - Street 1:30 3RD ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4832
Mailing Address - Country:US
Mailing Address - Phone:774-239-0193
Mailing Address - Fax:
Practice Address - Street 1:7706 101ST AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1914
Practice Address - Country:US
Practice Address - Phone:516-283-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist