Provider Demographics
NPI:1801545983
Name:FENG, LISA (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1647 PILGRIM AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4807
Mailing Address - Country:US
Mailing Address - Phone:347-215-1288
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE PLAINS RD FL 4
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5838
Practice Address - Country:US
Practice Address - Phone:914-556-4930
Practice Address - Fax:914-631-1949
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY336358207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine