Provider Demographics
NPI:1164590568
Name:VARGISH, LISA (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:VARGISH
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 1:2021 WINTON ROAD S.
Mailing Address - Street 2:JEWISH HOME OF ROCHESTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-784-6400
Mailing Address - Fax:585-341-2370
Practice Address - Street 1:2021 WINTON ROAD S.
Practice Address - Street 2:JEWISH HOME OF ROCHESTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-784-6400
Practice Address - Fax:585-341-2370
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36113681207Q00000X
NY253445207RG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine