Provider Demographics
NPI:1649529785
Name:TAYLOR, LISA GREAVES (CD(DONA), LCCE, CCCE)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:GREAVES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CD(DONA), LCCE, CCCE
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CD(DONA), LCCE, CCCE
Mailing Address - Street 1:2030 43RD ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1239
Mailing Address - Country:US
Mailing Address - Phone:646-249-9010
Mailing Address - Fax:
Practice Address - Street 1:2030 43RD ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1239
Practice Address - Country:US
Practice Address - Phone:646-249-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula