| Doctor Name: | LISA DANIELLI-PEASE |
| NPI Number: | 1043543259 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 004139 |
| Business Practice Address: | 21 Steiner Dr Mahopac, NY - 105411050 |
| Business Phone Number: | 8456288228 |
| Business Fax Number: | 8456286647 |
| Mailing Address: | 21 Steiner Dr, MAHOPAC |
| State: | NY |
| Postal Code: | 105411050 |
| Phone Number: | 8456288228 |
| Fax Number: | 8456286647 |
| NPI Enumeration Date: | 09/08/2009 |
| NPI Last Update Date: | 09/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZA2600X |
| License Number: | 004139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Art, Medical |
| Taxonomy Definition: | |