Basic Information
| Provider Information | |||||||||
| NPI: | 1306074745 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLMAN | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | MARGARET | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | SCARSDALE MEDICAL GROUP | ||||||||
| Address2: | 550 MAMARONECK AVENUE SUITE 302 | ||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147238100 | ||||||||
| FaxNumber: | 9142191928 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 EASTCHESTER RD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189042844 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2009 | ||||||||
| LastUpdateDate: | 09/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 253666 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.