Provider Demographics
NPI:1508828203
Name:CIAMACCO, LISA (RN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CIAMACCO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3710
Mailing Address - Country:US
Mailing Address - Phone:412-661-5500
Mailing Address - Fax:412-661-4760
Practice Address - Street 1:725 CHERRINGTON PKWY
Practice Address - Street 2:STE 200
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-4318
Practice Address - Country:US
Practice Address - Phone:412-262-7800
Practice Address - Fax:412-262-2277
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN269152L163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
936189OtherCERTIFICATE
PARN269152LOtherMEDICAL LICENSE