Provider Demographics
NPI:1972770543
Name:LITTMAN, LISA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:LITTMAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1057
Mailing Address - Street 2:17 EAST 102ND STREET
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0310
Mailing Address - Country:US
Mailing Address - Phone:212-824-7069
Mailing Address - Fax:
Practice Address - Street 1:17 E 102ND ST
Practice Address - Street 2:DEPT OF COMMUNITY AND PREVENTIVE MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5204
Practice Address - Country:US
Practice Address - Phone:212-824-7069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236268-1207V00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology