Provider Demographics
NPI:1891095188
Name:WEISINGER, LISA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:WEISINGER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 YORK ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5620
Mailing Address - Country:US
Mailing Address - Phone:203-777-6455
Mailing Address - Fax:203-789-1960
Practice Address - Street 1:100 YORK ST
Practice Address - Street 2:SUITE 2F
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5620
Practice Address - Country:US
Practice Address - Phone:203-777-6455
Practice Address - Fax:203-789-1960
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT040362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT040362OtherLICENSE NUMBER