Provider Demographics
NPI:1184987901
Name:FRISINO, LISA JANE
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JANE
Last Name:FRISINO
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 1:95 MAUREEN DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6676
Mailing Address - Country:US
Mailing Address - Phone:845-781-0497
Mailing Address - Fax:
Practice Address - Street 1:95 MAUREEN DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6676
Practice Address - Country:US
Practice Address - Phone:845-781-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist