Lisa Crocco

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

299 Hallock Ave
Port Jefferson Station, NY 11776-1217

Phone

(631) 473-4284

NPI assigned

Dec 26, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Matranga Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1255100772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 STRONG AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021815",
            "telephone_number": "631-258-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761217",
            "telephone_number": "631-473-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCCO",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MATRANGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer L Costa, AUD.
• Siobhan Bridget Costigliola
• Victoria A Courten, LMHC
• Jennifer Elizabeth Crabbe, LMSW
• Michelle Crain, LPN
• Kerry A Cronin, M.D.
• Stephen J Crovello, LCSW PC
• Jaclyn Roseann Cuccinello, NP
• Custom TRT US Inc
• Jesa Kiana Cuyugan

• Specialist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.