Provider Demographics
NPI:1366557027
Name:NORRIS, LISA LAGO (MD)
Entity type:Individual
Prefix:
First Name:LISA LAGO
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HUMMINGBIRD HOLW
Mailing Address - Street 2:
Mailing Address - City:SOUTHWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01077-9530
Mailing Address - Country:US
Mailing Address - Phone:413-569-0884
Mailing Address - Fax:
Practice Address - Street 1:5 HUMMINGBIRD HOLW
Practice Address - Street 2:
Practice Address - City:SOUTHWICK
Practice Address - State:MA
Practice Address - Zip Code:01077-9530
Practice Address - Country:US
Practice Address - Phone:413-569-0884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77086208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics