Doctor Name: | MRS. LISA KAY GERLACH |
NPI Number: | 1245591320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 575006-1 |
Business Practice Address: | 1100 State St Ogdensburg, NY - 136693352 |
Business Phone Number: | 3153930900 |
Business Fax Number: | |
Mailing Address: | 1100 State St, OGDENSBURG |
State: | NY |
Postal Code: | 136693352 |
Phone Number: | 3153930900 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2012 |
NPI Last Update Date: | 06/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 575006-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |