Provider Demographics
NPI:1235393869
Name:SZAINWALD, LISA
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:SZAINWALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 HUDSON ST
Mailing Address - Street 2:APT 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2465
Mailing Address - Country:US
Mailing Address - Phone:847-951-4111
Mailing Address - Fax:
Practice Address - Street 1:566 HUDSON ST
Practice Address - Street 2:APT 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2465
Practice Address - Country:US
Practice Address - Phone:847-951-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2008-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program