Provider Demographics
NPI:1396009049
Name:HOSEIN, LISA RHONDA (MS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:RHONDA
Last Name:HOSEIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13052 236TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1218
Mailing Address - Country:US
Mailing Address - Phone:917-806-5780
Mailing Address - Fax:
Practice Address - Street 1:13052 236TH ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1218
Practice Address - Country:US
Practice Address - Phone:917-806-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist