Healthcare Provider Details

I. General information

NPI: 1114903200
Provider Name (Legal Business Name): LISA E ZAMFINO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 WILLIAMS ST
PITTSFIELD MA
01201-7463
US

IV. Provider business mailing address

54 POOL HILL RD
NEW LEBANON NY
12125-3517
US

V. Phone/Fax

Practice location:
  • Phone: 413-447-8070
  • Fax: 413-445-4918
Mailing address:
  • Phone: 518-794-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12102
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: