Provider Demographics
NPI:1306934591
Name:PISANI, CRAIG LEWIS (NP)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:LEWIS
Last Name:PISANI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1714
Mailing Address - Country:US
Mailing Address - Phone:781-562-0468
Mailing Address - Fax:781-574-3926
Practice Address - Street 1:19 HENRY ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1714
Practice Address - Country:US
Practice Address - Phone:781-562-0468
Practice Address - Fax:781-574-3926
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254501363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health