Doctor Name: | MS. LISA MARIE CIRACO |
NPI Number: | 1124381496 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSED |
License Number: | 1177974 |
Business Practice Address: | 3228 Layton Ave Bronx, NY - 104651518 |
Business Phone Number: | 9176793212 |
Business Fax Number: | |
Mailing Address: | 3228 Layton Ave, BRONX |
State: | NY |
Postal Code: | 104651518 |
Phone Number: | 9176793212 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2012 |
NPI Last Update Date: | 06/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1177974 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |