Provider Demographics
NPI:1316114846
Name:DIBUCCI, LISA KATHRYN (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KATHRYN
Last Name:DIBUCCI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:KATHRYN
Other - Last Name:TORAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:0 UNIVERSITY DRIVE C
Mailing Address - Street 2:11C-U
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240-1001
Mailing Address - Country:US
Mailing Address - Phone:412-688-6000
Mailing Address - Fax:
Practice Address - Street 1:0 UNIVERSITY DRIVE C
Practice Address - Street 2:11C-U
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1001
Practice Address - Country:US
Practice Address - Phone:412-688-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN333371L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse