| Doctor Name: | MRS. LISA MARIE STAITI |
| NPI Number: | 1134445265 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | RS255919 |
| Business Practice Address: | 266 Main St Gardner, MA - 01440 |
| Business Phone Number: | 9786305030 |
| Business Fax Number: | 9786305033 |
| Mailing Address: | 100 Hospital Rd, Ste 4 LEOMINSTER |
| State: | MA |
| Postal Code: | 014532253 |
| Phone Number: | 9785146300 |
| Fax Number: | 9785146321 |
| NPI Enumeration Date: | 04/14/2010 |
| NPI Last Update Date: | 11/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | RS255919 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |