Healthcare Provider Details

I. General information

NPI: 1366485773
Provider Name (Legal Business Name): LISA WARD CIRILLO PT, CERT. MDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA ANNE WARD PT

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20684 JOHN J WILLIAMS HWY STE 2
LEWES DE
19958-4393
US

IV. Provider business mailing address

659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US

V. Phone/Fax

Practice location:
  • Phone: 302-945-0200
  • Fax: 302-945-6959
Mailing address:
  • Phone: 410-831-3226
  • Fax: 410-572-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0000575
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: