Provider Demographics
NPI:1467911834
Name:ARONOFSKY, LISA M (LMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:ARONOFSKY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 BERKLEY ST
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-1907
Mailing Address - Country:US
Mailing Address - Phone:774-451-1153
Mailing Address - Fax:
Practice Address - Street 1:65 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ASSONET
Practice Address - State:MA
Practice Address - Zip Code:02702-1015
Practice Address - Country:US
Practice Address - Phone:508-644-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA610236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist