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General NPI Number Information
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NPI Number | 1336170620
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Entity Type | Individual
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Provider Name | LISA CONNIFF PT
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 107 NP 502 PLZ
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City | MOSCOW
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State | PA
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Zip | 18444-9266
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Country | US
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Telephone | 570-848-1240
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Fax | 570-848-1243
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Provider Business Mailing Address
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Address Line | 509 SECOND AVENUE
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City | JESSUP
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State | PA
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Zip | 18434
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-011722L
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License Number State | PA
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