Provider Demographics
NPI:1003876228
Name:KURIAN, LISA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:KURIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E PUTNAM AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-1380
Mailing Address - Country:US
Mailing Address - Phone:203-524-9698
Mailing Address - Fax:203-242-4523
Practice Address - Street 1:1700 E PUTNAM AVE STE 407
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1380
Practice Address - Country:US
Practice Address - Phone:203-524-9698
Practice Address - Fax:203-242-4523
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232576207R00000X
CT047809207R00000X
CT47809208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine