Provider Demographics
NPI:1114200953
Name:COMITO, LISA W (OTR/L)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:W
Last Name:COMITO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3400
Mailing Address - Country:US
Mailing Address - Phone:401-885-0051
Mailing Address - Fax:401-885-0054
Practice Address - Street 1:5600 POST RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3400
Practice Address - Country:US
Practice Address - Phone:401-885-0051
Practice Address - Fax:401-885-0054
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist