| Doctor Name: | LISA DEGENNARO |
| NPI Number: | 1407139090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.S.W. |
| License Number: | 156061 |
| Business Practice Address: | 24537 60th Ave Little Neck, NY - 113622014 |
| Business Phone Number: | 7187288476 |
| Business Fax Number: | |
| Mailing Address: | 24537 60th Ave, LITTLE NECK |
| State: | NY |
| Postal Code: | 113622014 |
| Phone Number: | 7187288476 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2011 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 156061 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |