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NPI Code Detail

MEDICARE: JOSEPH LIZOTTE PA-C

MEDICARE: JOSEPH LIZOTTE PA-C
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
1224P00000XProsthetist
2363A00000XPhysician Assistant0010-08405NC

General Provider Information

NPI Number : 1700906922
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH LIZOTTE PA-C
Provider Business Mailing Address
First Line : 6112 SAINT GILES ST
Second Line :
City : RALEIGH
State : NC
Zip : 27612-7043
Country : US
Telephone Number : 919-893-4465
Fax Number :
Provider Business Practice Location Address
First Line : 6112 SAINT GILES ST
Second Line :
City : RALEIGH
State : NC
Zip : 27612-7043
Country : US
Telephone Number : 919-893-4465
Fax Number : 919-689-5350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 12/04/2024

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