Provider Demographics
NPI:1922183540
Name:MILANO, LISA A (MS,RD,CDN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:MILANO
Suffix:
Gender:F
Credentials:MS,RD,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 CROMPOND RD
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4329
Mailing Address - Country:US
Mailing Address - Phone:914-737-3664
Mailing Address - Fax:
Practice Address - Street 1:2127 CROMPOND RD
Practice Address - Street 2:SUITE 201A
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4329
Practice Address - Country:US
Practice Address - Phone:914-737-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000436-1133N00000X
NYR706804133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered