Doctor Name: | LISA THAYER |
NPI Number: | 1023050879 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 303834 |
Business Practice Address: | 841 Route 52 Fishkill, NY - 125241516 |
Business Phone Number: | 8458974350 |
Business Fax Number: | |
Mailing Address: | 4 Breeze Hill Rd, NEW WINDSOR |
State: | NY |
Postal Code: | 125538864 |
Phone Number: | 8455342592 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 303834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |