Provider Demographics
NPI:1306974258
Name:DEL POZO, LISA M (NP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:DEL POZO
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Gender:F
Credentials:NP
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Mailing Address - Street 1:421 S FRANKLIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7336
Mailing Address - Country:US
Mailing Address - Phone:516-280-5558
Mailing Address - Fax:866-278-1987
Practice Address - Street 1:421 S FRANKLIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7336
Practice Address - Country:US
Practice Address - Phone:516-280-5558
Practice Address - Fax:866-278-1987
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2016-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF333926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA3000055664Medicare UPIN