DR. LISA MARIE MACK (NPI# 1689985160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689985160 |
| Entity Type | Individual |
| Full Name | DR. LISA MARIE MACK |
| Credential | M.D. |
| Practice Address |
85 Seymour St Suite 1019 Hartford CT 06106-5501 |
| Mailing Address |
2110 Silas Deane Hwy Rocky Hill CT 06067-2313 |
| Practice Telephone | 8602464029 |
| Practice Fax Number | 8602407072 |
| Mailing Telephone | 8602583470 |
| Mailing Fax Number | 8605716800 |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2014-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 0048223 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CAQH | 12682481 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305248 | Lisa Danielle Mack | Registered Nurse | 1014 Harvest Grove Ct, Hope Mills, NC 28348-9272 | 2019-03-19 |
| 1154855872 | Lisa Mack | Specialist | 9351 Grant St Ste 480, Thornton, CO 80229-4375 | 2017-04-19 |
| 1366982852 | Lisa Mack | Student in an Organized Health Care Education/Training Program | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2017-03-02 |
| 1568822252 | Lisa Pascal Mack | Nurse Practitioner | 150 Park St, Lawrence, MA 01841-2517 | 2016-02-24 |
| 1629297346 | Lisa K Mack | Social Worker | 1022 Hamburg Tpke, Wayne, NJ 07470-3209 | 2007-04-24 |
| 1235153990 | Lisa R Mack | Emergency Medicine | 550 Peachtree St Ne, Atlanta, GA 30308-2247 | 2006-07-27 |
| 1699731737 | Lisa Mack | Social Worker | 2389 Jarco Dr, Holt, MI 48842-1209 | 2006-04-26 |
| Street Address |
85 SEYMOUR ST SUITE 1019 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-5501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770586471 | Daniel Bruce Fram | Internal Medicine | 85 Seymour St, Ste 821, Hartford, CT 06106 | 2005-05-27 |
| 1255841714 | Danielle Montufar Gleason | Psychologist | 85 Seymour St, Hartford, CT 06106-5501 | 2017-10-10 |
| 1164946760 | Christopher John Krupa-schayer | Nurse Practitioner | 85 Seymour St, Hartford, CT 06106-5501 | 2017-07-26 |
| 1902349251 | Courtney Leigh Davis | Nurse Practitioner | 85 Seymour St, Hartford, CT 06106-5501 | 2016-11-18 |
| 1669927703 | Hartford Healthcare Retail Pharmacy | Pharmacy | 85 Seymour St, Suite 117, Hartford, CT 06106-5501 | 2016-08-18 |
| 1013360254 | Praveen Jayapal | Student in an Organized Health Care Education/Training Program | 85 Seymour St, Hartford, CT 06106-5501 | 2016-07-22 |
| 1457702193 | Kevin Rooney | Physician Assistant | 85 Seymour St, Suite 409, Hartford, CT 06106-5501 | 2016-06-23 |
| 1922455211 | Molly Nathanson | Midwife | 85 Seymour St, Suite 1019, Hartford, CT 06106 | 2016-05-17 |
| 1386090124 | Allyson Rossi | Occupational Therapist | 85 Seymour St, Suite 604, Hartford, CT 06106-5501 | 2016-05-11 |
| 1639539554 | Daniel Gleason | Pharmacist | 85 Seymour St, Suite 117, Hartford, CT 06106-5501 | 2016-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093179624 | Jessica Lovesky | Obstetrics & Gynecology | 85 Seymour St Ste 1019, Hartford, CT 06106-5530 | 2016-04-10 |
| 1205218682 | Rui Wang | Obstetrics & Gynecology | 85 Seymour St Ste 525, Hartford, CT 06106-5525 | 2015-06-23 |
| 1881960201 | Loretta Ruth Hallock | Obstetrics & Gynecology | 114 Woodland St., St. Francis Hospital, Hartford, CT 06105 | 2012-03-29 |
| 1134449697 | Stephanie L Bakaysa | Obstetrics & Gynecology | 85 Jefferson St Ste 625, Hartford Hospital Maternal Fetal Medicine, Hartford, CT 06106 | 2010-06-08 |
| 1114048329 | Jonathan Paul Shepherd | Obstetrics & Gynecology | 114 Woodland St Dept Of, Hartford, CT 06105-1208 | 2007-04-03 |
| 1609942416 | Gene David Kirschenbaum | Obstetrics & Gynecology | 360 Market Street, Hartford, CT 06120 | 2006-11-27 |
| 1902909088 | Leonard Lippman | Obstetrics & Gynecology | 449 Farmington Ave, Hartford, CT 06105 | 2006-09-06 |
| 1639272719 | Randy Berke | Obstetrics & Gynecology | 449 Farmington Avenue, Hartford, CT 06105 | 2006-09-06 |
| 1538182068 | Janice Hartnett | Obstetrics & Gynecology | 136 Retreat Ave, Hartford, CT 06106-2529 | 2006-07-25 |
| 1265474340 | Gary Francis Nobert | Obstetrics & Gynecology | Hartford Hospital Ob Gyn Dept, 80 Seymour Street, Hartford, CT 06102 | 2006-06-12 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.