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General NPI Number Information
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NPI Number | 1851470116
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Entity Type | Individual
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Provider Name | DENISE A LISI P.A.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1205 TROY SCHENECTADY RD STE 101
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City | LATHAM
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State | NY
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Zip | 12110-1074
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Country | US
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Telephone | 518-348-3176
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Fax |
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Provider Business Mailing Address
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Address Line | 7 PEBBLE BEACH DR
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City | CLIFTON PARK
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State | NY
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Zip | 12065-1106
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Country | US
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Telephone | 518-369-7493
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 005033
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 005033
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License Number State | NY
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