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NPI Code Detail

MEDICARE: MS. DEBORAH J. LISI R.N.

MEDICARE:  MS. DEBORAH J. LISI  R.N.
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
1207Q00000XFamily Medicine PhysicianRN16298RI

General Provider Information

NPI Number : 1639183619
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH J. LISI R.N.
Provider Business Mailing Address
First Line : 311 DORIC AVE
Second Line :
City : CRANSTON
State : RI
Zip : 02910-2903
Country : US
Telephone Number : 401-467-9610
Fax Number : 401-467-9610
Provider Business Practice Location Address
First Line : 1090 CRANSTON ST
Second Line :
City : CRANSTON
State : RI
Zip : 02920-7323
Country : US
Telephone Number : 401-943-1981
Fax Number : 401-943-2846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 07/08/2007

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Directions to “ MS. DEBORAH J. LISI R.N.” Practice Location

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