Provider Demographics
NPI:1740077882
Name:ALTOBELLI, LISA M
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:ALTOBELLI
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 1:276 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-7116
Mailing Address - Country:US
Mailing Address - Phone:440-610-0640
Mailing Address - Fax:440-610-0640
Practice Address - Street 1:276 COLGATE AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-7116
Practice Address - Country:US
Practice Address - Phone:440-610-0640
Practice Address - Fax:440-610-0640
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker