MEDICARE: MRS. LISA CIOFFI MSN, RN, CWON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX1500X	Ostomy Care Registered Nurse	63654	CT

General Provider Information

NPI Number	:	1285391417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA CIOFFI MSN, RN, CWON

Provider Business Mailing Address
First Line	:	72 PETTIT DR
Second Line	:
City	:	MERIDEN
State	:	CT
Zip	:	06451-4971
Country	:	US
Telephone Number	:	203-214-7373
Fax Number	:	203-785-2615

Provider Business Practice Location Address
First Line	:	789 HOWARD AVE
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1300
Country	:	US
Telephone Number	:	203-785-2616
Fax Number	:	203-785-2615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2021
Last Update Date	:	11/22/2021

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