Provider Demographics
NPI:1407915523
Name:LEMPEL-SANDER, LISA ELLEN (L)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ELLEN
Last Name:LEMPEL-SANDER
Suffix:
Gender:F
Credentials:L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1111
Mailing Address - Country:US
Mailing Address - Phone:718-225-0552
Mailing Address - Fax:718-225-3683
Practice Address - Street 1:221 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1111
Practice Address - Country:US
Practice Address - Phone:718-225-0552
Practice Address - Fax:718-225-3683
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000369-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst