Healthcare Provider Details

I. General information

NPI: 1053771964
Provider Name (Legal Business Name): LISA IORIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FRONT ST FL 11
WORCESTER MA
01608-1425
US

IV. Provider business mailing address

100 FRONT ST FL 11
WORCESTER MA
01608-1425
US

V. Phone/Fax

Practice location:
  • Phone: 508-425-5694
  • Fax: 508-853-7149
Mailing address:
  • Phone: 508-425-5694
  • Fax: 508-853-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07170084
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: