| Doctor Name: | MS. LISA ANNE COOLEEN |
| NPI Number: | 1023270972 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | F420719 |
| Business Practice Address: | 4277 Hempstead Tpke Suite 102 Bethpage, NY - 117145709 |
| Business Phone Number: | 5167315100 |
| Business Fax Number: | 5167313758 |
| Mailing Address: | 23 Whisper Ln, WANTAGH |
| State: | NY |
| Postal Code: | 117931231 |
| Phone Number: | 5165207792 |
| Fax Number: | 5167313758 |
| NPI Enumeration Date: | 07/01/2008 |
| NPI Last Update Date: | 07/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | F420719 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |