NPI 1295741825 · live from the CMS NPI Registry
Lisa Marie Ambrogio-Decola, PA
Physician Assistant, Surgical in Meriden, CT. National Provider Identifier 1295741825, active.
NPI record
| NPI | 1295741825 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 435 Lewis Ave Ste 103, Meriden, CT 06451 |
| Practice phone | 203-694-7550 |
| Mailing address | 435 Lewis Ave, Ste 103, Meriden, CT 06451 |
| Enumerated | August 1, 2006 |
| Last updated | June 26, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical primary | 363AS0400X | 001246 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.