Healthcare Provider Details

I. General information

NPI: 1306846324
Provider Name (Legal Business Name): LISA D. CURCIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 SPRING BROOK AVE STE 101
RHINEBECK NY
12572-3709
US

IV. Provider business mailing address

1351 ROUTE 55 STE 200
LAGRANGEVILLE NY
12540-5128
US

V. Phone/Fax

Practice location:
  • Phone: 845-871-3545
  • Fax: 845-871-3546
Mailing address:
  • Phone: 845-475-9661
  • Fax: 845-475-9938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number306263
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG78151
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number306263
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberG78151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: