Provider Demographics
NPI:1831218866
Name:HERMAN, LIZ (ND)
Entity type:Individual
Prefix:DR
First Name:LIZ
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:BUFFY
Other - Middle Name:LIZETT
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:474 MAIN ST
Mailing Address - Street 2:APT #2
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508
Mailing Address - Country:US
Mailing Address - Phone:914-906-6552
Mailing Address - Fax:
Practice Address - Street 1:10B ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801
Practice Address - Country:US
Practice Address - Phone:203-748-4447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000230175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath