Lisa D. Ocque
Individual provider Active NPI Specialist · Ontario, NY
NPI 1285901645 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1285901645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 011267-1 (NY)
- Practice address
- 7279 Pear Tree MDWS
Ontario, NY 14519-9618 - Phone
- (315) 576-0646
- NPI assigned
- Nov 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011267-1 | NY | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 011267-1 | NY | Yes |
Addresses
Primary practice location
7279 Pear Tree MDWS
Ontario, NY 14519-9618
Mailing address
7279 Pear Tree MDWS
Ontario, NY 14519-9618
Phone (315) 576-0646
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740332444 | Medicaid | NY |
Other providers in Ontario, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.