Healthcare Provider Details

I. General information

NPI: 1396941548
Provider Name (Legal Business Name): LISE CRAPELLA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 LAFAYETTE AVE
SUFFERN NY
10901-4812
US

IV. Provider business mailing address

20 GRAND STREET, 3RD FL
WARWICK NY
10990-1035
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-5000
  • Fax: 845-368-5169
Mailing address:
  • Phone: 845-368-5951
  • Fax: 845-987-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberF303096-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: