Provider Demographics
NPI:1710083449
Name:OZICK, LISA A (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:OZICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WINCHESTER OVAL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-2910
Mailing Address - Country:US
Mailing Address - Phone:914-235-5862
Mailing Address - Fax:
Practice Address - Street 1:40 WINCHESTER OVAL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-2910
Practice Address - Country:US
Practice Address - Phone:914-235-5862
Practice Address - Fax:914-881-9000
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152733207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology