Individual
LISA MARIE AMBROGIO-DECOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
435 LEWIS AVE STE 103, MERIDEN, CT 06451-2101
(203) 694-7550
(203) 694-7555
Mailing address
435 LEWIS AVE, STE 103, MERIDEN, CT 06451-2101
(203) 789-3997
(203) 867-5216
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001246
CT
Other
Enumeration date
08/01/2006
Last updated
06/26/2019
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