| Doctor Name: | MS. LISA FERAZZOLI |
| NPI Number: | 1104070911 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPA-C |
| License Number: | 012988 |
| Business Practice Address: | 114-12 Beach Channel Drive Rockaway Park, NY - 116942215 |
| Business Phone Number: | 7183186021 |
| Business Fax Number: | 7183184802 |
| Mailing Address: | 114-12 Beach Channel Drive, ROCKAWAY PARK |
| State: | NY |
| Postal Code: | 116942215 |
| Phone Number: | 7183186021 |
| Fax Number: | 7183184802 |
| NPI Enumeration Date: | 11/06/2008 |
| NPI Last Update Date: | 12/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 012988 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |