Provider Demographics
NPI:1598880809
Name:SOKAC, LISA MARIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:SOKAC
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:MALOLEPSZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:4901 LAC DE VILLE BLVD
Mailing Address - Street 2:BLDG D, SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5647
Mailing Address - Country:US
Mailing Address - Phone:585-341-9150
Mailing Address - Fax:
Practice Address - Street 1:4901 LAC DE VILLE BLVD
Practice Address - Street 2:BLDG D, SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5647
Practice Address - Country:US
Practice Address - Phone:585-341-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0009332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NATAOtherNATIONAL ATHLETIC TRAINER