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Individual

MS. LISA A MELLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

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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