Provider Demographics
NPI:1194943399
Name:LISI, PAUL ALDO (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALDO
Last Name:LISI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 S LAKE DR
Mailing Address - Street 2:PULMONARY AND CRITICAL CARE
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-3171
Mailing Address - Country:US
Mailing Address - Phone:414-489-4260
Mailing Address - Fax:414-489-4022
Practice Address - Street 1:5900 S LAKE DR
Practice Address - Street 2:PULMONARY AND CRITICAL CARE
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3171
Practice Address - Country:US
Practice Address - Phone:414-489-4260
Practice Address - Fax:414-489-4022
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52242-21207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine