Provider Demographics
NPI:1841609039
Name:DIPALERMO, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DIPALERMO
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 1:32 INDIAN ROCK RD
Mailing Address - Street 2:UNIT 5
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1697
Mailing Address - Country:US
Mailing Address - Phone:603-890-8541
Mailing Address - Fax:603-890-8736
Practice Address - Street 1:32 INDIAN ROCK RD
Practice Address - Street 2:UNIT 5
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1697
Practice Address - Country:US
Practice Address - Phone:603-890-8541
Practice Address - Fax:603-890-8736
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist