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General NPI Number Information
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NPI Number | 1306855275
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Entity Type | Individual
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Provider Name | LISA A. PRINCIPE M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | ANDALUZ Z-#1 LOMAS VERDES
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-778-2268
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Fax | 787-778-2268
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Provider Business Mailing Address
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Address Line | 100 GRAND BULEVARD PASEOS SUITE 112 MSC 333
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City | SAN JUAN
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State | PR
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Zip | 00926-5955
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Country | US
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Telephone | 787-778-2268
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Fax | 787-778-2268
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9828
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License Number State | PR
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