Provider Demographics
NPI:1558442517
Name:JANOWSKI, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:JANOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1571 DAIRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:S ROYALTON
Mailing Address - State:VT
Mailing Address - Zip Code:05068-5253
Mailing Address - Country:US
Mailing Address - Phone:802-763-7183
Mailing Address - Fax:
Practice Address - Street 1:5 ROPE FERRY RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1404
Practice Address - Country:US
Practice Address - Phone:603-650-1426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other