Provider Demographics
NPI:1366703498
Name:CATAPANO, LISA
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CATAPANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MAPLELEAF LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2111
Mailing Address - Country:US
Mailing Address - Phone:516-233-1801
Mailing Address - Fax:
Practice Address - Street 1:35 MAPLELEAF LN
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2111
Practice Address - Country:US
Practice Address - Phone:516-233-1801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor