Provider Demographics
NPI:1457421950
Name:ABATE, LISA KAY (DO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:ABATE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 CHAPEL DR STE D
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1344
Mailing Address - Country:US
Mailing Address - Phone:419-424-1922
Mailing Address - Fax:
Practice Address - Street 1:1818 CHAPEL DR STE D
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1344
Practice Address - Country:US
Practice Address - Phone:419-424-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007444207R00000X, 208000000X, 208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2498060Medicaid
IN200842140Medicaid
IN815500BB7Medicare PIN
IN200842140Medicaid
IN000000632526OtherANTHEM PROVIDER NUMBER