Provider Demographics
NPI:1770945800
Name:RIPI-HANEMANN, LISA MARIE (DIPLAC, LAC, LMT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:RIPI-HANEMANN
Suffix:
Gender:F
Credentials:DIPLAC, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2409
Mailing Address - Country:US
Mailing Address - Phone:516-287-3777
Mailing Address - Fax:
Practice Address - Street 1:1298 CHELSEA RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2409
Practice Address - Country:US
Practice Address - Phone:516-287-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000751-1171100000X
NY005437-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist