Provider Demographics
NPI:1528125432
Name:LISA P. LIPARI, DC, PLLC
Entity type:Organization
Organization Name:LISA P. LIPARI, DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:PIERA
Authorized Official - Last Name:LIPARI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-698-6666
Mailing Address - Street 1:1150 PORTION RD
Mailing Address - Street 2:SUITE 17
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1074
Mailing Address - Country:US
Mailing Address - Phone:631-698-6666
Mailing Address - Fax:
Practice Address - Street 1:1150 PORTION RD
Practice Address - Street 2:SUITE 17
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1074
Practice Address - Country:US
Practice Address - Phone:631-698-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXAWDF1Medicare ID - Type UnspecifiedGROUP #