Provider Demographics
NPI:1922276278
Name:LONGWORTH-GATTO, LISA (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:LONGWORTH-GATTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:LONGWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:160 HANOVER AVENUE
Mailing Address - Street 2:P.O. BOX 1446
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962
Mailing Address - Country:US
Mailing Address - Phone:973-538-2334
Mailing Address - Fax:
Practice Address - Street 1:160 HANOVER AVENUE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-538-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07494300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine