Individual provider Active NPI

Lisa Ann Assaiante

  • Specialist
  • Warwick, NY
National Provider Identifier
1104176908
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
619636121 Issued in NY
Practice address
21 Sunset Ter
Warwick, NY 10990-2143
Phone
(845) 544-1488
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 619636121 NY Primary

Addresses

Primary practice location

21 Sunset Ter
Warwick, NY 10990-2143

Mailing address

21 Sunset Ter
Warwick, NY 10990-2143
Phone (845) 544-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
619636121NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1104176908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SUNSET TER",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902143",
            "telephone_number": "845-544-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUNSET TER",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902143",
            "telephone_number": "845-544-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSAIANTE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "619636121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.