Provider Demographics
NPI:1386406411
Name:BINETTI, LISA M
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:BINETTI
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 1:25 RODERICK RD
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-2615
Mailing Address - Country:US
Mailing Address - Phone:631-539-2726
Mailing Address - Fax:
Practice Address - Street 1:25 RODERICK RD
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-2615
Practice Address - Country:US
Practice Address - Phone:631-539-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist