Basic Information
Provider Information
NPI: 1609091933
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NASON
FirstName: LISA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 219 BOULDER RIDGE RD
Address2:  
City: SCARSDALE
State: NY
PostalCode: 105833151
CountryCode: US
TelephoneNumber: 9144783206
FaxNumber: 9142316759
Practice Location
Address1: 2422 CENTRAL PK AVE
Address2:  
City: YONKERS
State: NY
PostalCode: 107101125
CountryCode: US
TelephoneNumber: 9147792995
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 09/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X178214NYY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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