Provider Demographics
NPI:1841390853
Name:AIRAN, LISA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ELIZABETH
Last Name:AIRAN
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 1:45 EAST 25TH STREET
Mailing Address - Street 2:APT 28A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:212-213-6288
Mailing Address - Fax:
Practice Address - Street 1:910 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-400-0999
Practice Address - Fax:212-400-0991
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMD211745207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09U003Medicare ID - Type Unspecified
G48850Medicare UPIN