National Provider Identifier

Lisa Marie Forestal, PA

Lisa Marie Forestal, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Buffalo, NY and a listed phone number of (716) 859-1254.

NPI 1205975232Buffalo, NYPhysician Assistant

Profile Overview

NPI
1205975232
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
February 06, 2007
Last Updated
November 25, 2009

Practice Location

  • 100 High St
  • Buffalo, NY 14203-1126

Phone: (716) 859-1254

Mailing Address

  • 3435 Main St
  • Hayes A
  • Buffalo, NY 14214-3001

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1205975232
Entity Type
Individual
Last Name
Forestal
First Name
Lisa
Middle Name
Marie
Credential
PA
Provider Other Last Name
Weller
Provider Other First Name
Lisa
Provider Other Middle Name
Marie
Provider Other Last Name Type Code
1
Mailing Street Address
3435 Main St
Mailing Address Line 2
Hayes A
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14214-3001
Mailing Country
US
Mailing Phone
(716) 829-3670
Practice Street Address
100 High St
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14203-1126
Practice Country
US
Practice Phone
(716) 859-1254
Practice Fax
(716) 859-4586
Enumeration Date
February 06, 2007
Last Updated
November 25, 2009
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
011316 (NY, PA License)