Provider Demographics
NPI:1194372060
Name:CIRIGLIANO, LISA LYN (CNM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LYN
Last Name:CIRIGLIANO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LYN
Other - Last Name:WASNOFSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:56 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1838
Mailing Address - Country:US
Mailing Address - Phone:516-526-3213
Mailing Address - Fax:
Practice Address - Street 1:232 WEST 80TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:646-962-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001953176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife