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General NPI Number Information
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NPI Number | 1306955224
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Entity Type | Individual
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Provider Name | ALFRED MICHAEL LISANTI LAC.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 266 WHITE PLAINS RD., SUITE B-1
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City | EASTCHESTER
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State | NY
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Zip | 10709
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Country | US
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Telephone | 914-337-2980
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Fax | 914-346-5650
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Provider Business Mailing Address
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Address Line | 3 MUSKET DR
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City | HOLBROOK
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State | NY
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Zip | 11741-5209
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Country | US
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Telephone | 631-681-5346
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Fax | 914-961-8489
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 003149
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License Number State | NY
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