Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Lisa Michelle Tannenbaum, PA-C

Individual provider Physician Assistant · NPI 1114578507

MS. Lisa Michelle Tannenbaum, PA-C is a Physician Assistant in Farmingville, New York. Licensed in New York. Registered with an NPI since 2019.

Licensed in
NY
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

100 Granny Rd Unit 2
Farmingville, NY 11738-2879
Phone: (631) 696-4357
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1164958 (NY)

Record details

NPI number1114578507
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 26, 2019
Last updated in NPPESSeptember 26, 2019

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