Provider Demographics
NPI:1578073276
Name:LISA S. BALL, FAMILY HEALTH NP, PLLC
Entity Type:Organization
Organization Name:LISA S. BALL, FAMILY HEALTH NP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SHERRY
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:716-982-4165
Mailing Address - Street 1:146 SAGEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4718
Mailing Address - Country:US
Mailing Address - Phone:716-982-4165
Mailing Address - Fax:
Practice Address - Street 1:1140 YOUNGS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8054
Practice Address - Country:US
Practice Address - Phone:716-688-0020
Practice Address - Fax:716-688-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-07
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1104366368OtherNP EMPLOYEE - J TUROWSKI
NY1497802672OtherNPI 1 OF PRACTICE OWNER
NY1477606796OtherCONSULTING PHYSICIAN - DR. NEIMAN
NY1972624252OtherNP EMPLOYEE OF PRACTICE - M MELE-DELGADO