Provider Demographics
NPI:1043277767
Name:LIENHARD, GISELA G (MD)
Entity Type:Individual
Prefix:DR
First Name:GISELA
Middle Name:G
Last Name:LIENHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:10N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8183
Mailing Address - Country:US
Mailing Address - Phone:212-355-1712
Mailing Address - Fax:212-355-1713
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:10N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8183
Practice Address - Country:US
Practice Address - Phone:212-355-1712
Practice Address - Fax:212-355-1713
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY97527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP750OtherOXFORD
159018OtherUNITED HEALTH
NP750OtherOXFORD
B20204Medicare UPIN