Gussak, Lisa S

Gussak, Lisa S is an individual health care provider with primary practice located at 26 Queen St Family Practice 1, Worcester MA 01610-2473. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gussak, Lisa S can be contacted via phone (508) 860-7700.

Contact Information

Primary practice address
26 Queen St Family Practice 1 Worcester MA 01610-2473
Phone: (508) 860-7700
Fax: (508) 860-7929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 155167 Massachusetts

Profile Details

NPI number 1780667543
LBN Legal business name Gussak, Lisa S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Oct 24th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780667543 NPPES
Massachusetts MEDICAID 0109061

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