Provider Demographics
NPI:1720397334
Name:AIELLO-BAYER, LISA ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:AIELLO-BAYER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:AIELLO-BAYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:42 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1304
Mailing Address - Country:US
Mailing Address - Phone:845-282-8305
Mailing Address - Fax:
Practice Address - Street 1:25 SAINT JAMES PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1200
Practice Address - Country:US
Practice Address - Phone:914-261-0629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004828-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist