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Contact Information

BOAZ J LISSAUER, MD
1036 PARK AVE
SUITE 1C
NEW YORK, NY10028-0971
 Phone: 212-717-2150
 Fax: 212-717-2154
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BOAZ J LISSAUER · (Male)

NPI # 1639173123
Status Active
Credentials MD
Entity Individual
Enumeration date 06/13/2005
Last updated 06/25/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MA07699200
  • NY License # 208452
  • Other 7554155 AETNA
  • Other P2647045 OXFORD
  • NY Other 1000035875 AFFNITY HEALTH PLAN
  • NY Other BL0482B310 BLUE CROSS BLUE SHIELD
  • NY Other 271252B DIVISION 1181 MAGNACARE
  • NY Other BL0482B310 FEDERAL BLUE CROSS BLUE S
  • NY Other 0498250 GHI
  • NY Other 208452 HIP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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