Individual
MS. LISA A MELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1524 ATWOOD AVE, DBA/ROBERT BUONANNO, JOHNSTON, RI 02919-3228
(401) 351-6200
(401) 351-6201
Mailing address
1524 ATWOOD AVE, DBA/ROBERT BUONANNO, JOHNSTON, RI 02919-3228
(401) 351-6200
(401) 351-6201
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00687
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050397249
UNITEDHEALTHCARE
RI
01
—
050397249
PEQUOT PLUS HEALTH PLANS
—
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
—
Enumeration date
05/10/2006
Last updated
04/08/2009
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