Provider Demographics
NPI:1427380161
Name:PAULIS, LISA VASANT (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:VASANT
Last Name:PAULIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:VASANT
Other - Last Name:ASGAONKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:170 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4648
Mailing Address - Country:US
Mailing Address - Phone:585-758-7006
Mailing Address - Fax:
Practice Address - Street 1:170 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4648
Practice Address - Country:US
Practice Address - Phone:585-442-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260743174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist