Provider Demographics
NPI:1770574055
Name:BABITZ, LISA E (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:BABITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:BABITZ GREISMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:457 W 57TH ST
Mailing Address - Street 2:APT 106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1701
Mailing Address - Country:US
Mailing Address - Phone:212-265-1471
Mailing Address - Fax:
Practice Address - Street 1:457 W 57TH ST
Practice Address - Street 2:APT 106
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1701
Practice Address - Country:US
Practice Address - Phone:212-265-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157729207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNP948OtherOXFORD
NYA63628Medicare UPIN
NY65D171Medicare PIN