Provider Demographics
NPI:1275836256
Name:LISA PERRINO INC
Entity Type:Organization
Organization Name:LISA PERRINO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PERRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-245-5868
Mailing Address - Street 1:515 CHAPMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-9591
Mailing Address - Country:US
Mailing Address - Phone:631-909-3346
Mailing Address - Fax:631-909-3346
Practice Address - Street 1:515 CHAPMAN BLVD
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949
Practice Address - Country:US
Practice Address - Phone:631-909-3346
Practice Address - Fax:631-909-3346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY599476311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home