Jacobsen, Lisa J

Jacobsen, Lisa J is an individual health care provider with primary practice located at 462 Grider St , Buffalo NY 14215-3021. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jacobsen, Lisa J can be contacted via phone (716) 898-3000.

Contact Information

Primary practice address
462 Grider St Buffalo NY 14215-3021
Phone: (716) 898-3000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 285489 New York

Profile Details

NPI number 1518943091
LBN Legal business name Jacobsen, Lisa J
Credentials MD, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Oct 11th, 2017 - about 9 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 1518943091 NPPES
New York MEDICAID 04497090
New York MEDICAID 3141446

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