Provider Demographics
NPI:1871568360
Name:LIPARI, LISA PIERA (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:PIERA
Last Name:LIPARI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 PORTION RD
Mailing Address - Street 2:SUITE 17
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1074
Mailing Address - Country:US
Mailing Address - Phone:631-698-6666
Mailing Address - Fax:631-698-0699
Practice Address - Street 1:1150 PORTION RD
Practice Address - Street 2:SUITE 17
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1074
Practice Address - Country:US
Practice Address - Phone:631-698-6666
Practice Address - Fax:631-698-0699
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXAWDF1Medicare ID - Type UnspecifiedMEDICARE GROUP #
NYX4N951Medicare ID - Type UnspecifiedMEDICARE PROVIDER #