Doctor Name: | LISA MARIE BUTERA-SGOUROS |
NPI Number: | 1356603286 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS-SPECIAL EDUCATION |
License Number: | 2443 |
Business Practice Address: | 1706 Park St Atlantic Beach, NY - 115091536 |
Business Phone Number: | 5162984840 |
Business Fax Number: | 5163714840 |
Mailing Address: | 1706 Park St, ATLANTIC BEACH |
State: | NY |
Postal Code: | 115091536 |
Phone Number: | 5162984840 |
Fax Number: | 5163714840 |
NPI Enumeration Date: | 06/15/2012 |
NPI Last Update Date: | 06/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2443 |
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. |