MEDICARE: DR. LISA PAGLIARO ANDRIANOPOULOS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist		MA

General Provider Information

NPI Number	:	1225884240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA PAGLIARO ANDRIANOPOULOS PHD

Provider Business Mailing Address
First Line	:	375 SALISBURY ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1427
Country	:	US
Telephone Number	:	917-747-1021
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 HARTWELL AVE
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-3160
Country	:	US
Telephone Number	:	781-555-5678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	04/29/2024

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