Active NPI
Lisa Marie Denisco, MPT
- Neurology Physical Therapist
- East Northport, NY
National Provider Identifier
1730202128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 022371
- Practice address
- 4 Patrician CT.
East Northport, NY 11731 - Phone
- (631) 261-1036
- Fax
- (516) 731-1306
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | 022371 | NY | Primary |
Addresses
Primary practice location
4 Patrician CT.
East Northport, NY 11731
Mailing address
4 Patrician CT.
East Northport, NY 11731
Phone (631) 261-1036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090909000333 | NY | Practitioner - Physical Therapist in Private Practice | 8628123023 | Practice locations: East Northport, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022371 | NY | MD | Neurology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427068800000",
"number": "1730202128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 PATRICIAN CT.",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "11731",
"telephone_number": "631-261-1036",
"fax_number": "516-731-1306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 PATRICIAN CT.",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "11731",
"telephone_number": "631-261-1036",
"fax_number": "516-731-1306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENISCO",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2015-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "NY",
"license": "022371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.