# MS. LISA A MELLOW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1043269582
- **Gender:** F
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT00687 | RI | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 04/08/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 050397249 | UNITEDHEALTHCARE | RI |
| 01 | — | 050397249 | FIRST HLTH/COVENTRY/HCVM | — |
| 01 | — | 0771230001 | DMEMAC REGION A | MA |
| 01 | — | 0771230001 | DME REGION C | SC |
| 01 | — | 1043269582 | TUFTS HEALTH PLANS | — |
| 01 | — | 1215115 | COVENTRY HEALTH | — |
| 01 | — | 12296688 | MULTIPLAN | — |
| 01 | — | 204194/409026 | BLUECHIP | RI |
| 01 | — | 27673 | NEIGHBORHOOD HEALTH PLANS | RI |
| 01 | — | 7354 | BCBS | RI |
| 01 | — | AA64883 | HARVARD HEALTH PLANS | MA |
| 01 | — | CD1829 | RAILROAD MEDICARE | — |