Provider Demographics
NPI:1740011535
Name:DI LISI, NICHOLAS J
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:DI LISI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 STATE ROUTE 323
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:OH
Mailing Address - Zip Code:43143-9416
Mailing Address - Country:US
Mailing Address - Phone:614-512-5358
Mailing Address - Fax:
Practice Address - Street 1:7550 STATE ROUTE 323
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:OH
Practice Address - Zip Code:43143-9416
Practice Address - Country:US
Practice Address - Phone:614-512-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide