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General NPI Number Information
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NPI Number | 1609925999
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Entity Type | Individual
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Provider Name | LISA ANNE MASCALL PT, LAC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 50 CLINTON PL
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City | HACKENSACK
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State | NJ
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Zip | 07601-4579
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Country | US
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Telephone | 201-561-1240
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Fax |
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Provider Business Mailing Address
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Address Line | 50 CLINTON PL
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City | HACKENSACK
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State | NJ
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Zip | 07601-4579
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Country | US
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Telephone | 201-561-1240
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 005836
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 027805-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01027200
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00130000
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License Number State | NJ
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