Provider Demographics
NPI:1831342161
Name:NOTARO-PANE, LISA (RD)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:NOTARO-PANE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SOMERSET KNOLL
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509
Mailing Address - Country:US
Mailing Address - Phone:845-278-2537
Mailing Address - Fax:
Practice Address - Street 1:907 SOMERSET KNOLL
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509
Practice Address - Country:US
Practice Address - Phone:845-278-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered