Provider Demographics
NPI:1114903200
Name:ZAMFINO, LISA E (PT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:ZAMFINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 POOL HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW LEBANON
Mailing Address - State:NY
Mailing Address - Zip Code:12125-3517
Mailing Address - Country:US
Mailing Address - Phone:518-794-8182
Mailing Address - Fax:
Practice Address - Street 1:740 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7463
Practice Address - Country:US
Practice Address - Phone:413-447-8070
Practice Address - Fax:413-445-4918
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10078458OtherCDPHP
MA435809OtherMVP
MAZAY67570OtherBCBS OF MASSACHUSETTS
MA0314056Medicaid
MAY68100Medicare ID - Type Unspecified