Kristine M Lisi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042871 Issued in CT

Practice address

762 Lindley St
Bridgeport, CT 06606-5046

Phone

(203) 576-5440

Fax

(203) 581-6509

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1477588754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-5440",
            "fax_number": "203-581-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 LINDLEY ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065046",
            "telephone_number": "203-576-5440",
            "fax_number": "203-581-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISI",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "042871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004187812",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001428714",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victor Linzau, PA-C
• Leonard Lipton, DDS
• Aimee L Liseo, R.D.H.
• Julia Lisi, CRNA
• Kenneth R Lisi, MD
• Rose Lisi, RN
• Marie Dorothea Lisieski, LCSW
• Paige Lisk
• Little Big Steps, LLC
• Ebonee Little, LCSW

• Internal Medicine Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.