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Lisa Ann Eberhardt

NPI Registration Record

Provider / OrganizationNPIDate Certified
LISA ANN EBERHARDT16397964852020-06-28
Entity TypeIndividual
Provider NameMs. Lisa Ann Eberhardt FNP-BC
Practice Office Address4 PATRIOT DR
GLENMONT, NY US
Practice Office Telephone8455947063
Mailing Address4 PATRIOT DR
GLENMONT, NY 120773250 US
Business Telephone8455947063
HPT Codes
CodeLicense NoState
363LF0000X PRIMARY345936 NY
OPI Codes

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