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NPI Code Detail

MEDICARE: MRS. LISA BANIAN NP-C

MEDICARE: MRS. LISA BANIAN NP-C
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
1363LF0000XFamily Nurse PractitionerRN276936MA
2363L00000XNurse PractitionerRN276936MA

General Provider Information

NPI Number : 1598174120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA BANIAN NP-C
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number : 800-225-8885
Fax Number : 508-334-1977
Provider Business Practice Location Address
First Line : 100 COMMERCE DR
Second Line :
City : NORTHBRIDGE
State : MA
Zip : 01534-1415
Country : US
Telephone Number : 508-372-3510
Fax Number : 508-234-2627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2014
Last Update Date : 03/30/2026

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Directions to “ MRS. LISA BANIAN NP-C” Practice Location

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