Provider Demographics
NPI:1518279736
Name:TROY, LISA S (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:S
Last Name:TROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:S
Other - Last Name:KREMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MDM
Mailing Address - Street 1:1002 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-2204
Mailing Address - Country:US
Mailing Address - Phone:201-390-0955
Mailing Address - Fax:
Practice Address - Street 1:171 RAMAPO RD
Practice Address - Street 2:NORTH ROCKLAND PEDIATRICS
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1552
Practice Address - Country:US
Practice Address - Phone:845-947-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257756208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics