Provider Demographics
NPI:1952561045
Name:PATRICK, LISA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:PATRICK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:130 E 77TH ST
Mailing Address - Street 2:3 BLACK HALL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1851
Mailing Address - Country:US
Mailing Address - Phone:212-434-3191
Mailing Address - Fax:212-434-3306
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:3 BLACK HALL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-434-3191
Practice Address - Fax:212-434-3306
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2010-08-02
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Provider Licenses
StateLicense IDTaxonomies
NY2356272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry