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Individual

MRS. LISA MARIE TACORONTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
383 HAZLE TOWNSHIP BLVD, HAZLE TOWNSHIP, PA 18202-9659
(866) 454-7620
Mailing address
383 HAZLE TOWNSHIP BOULEVARD, HAZLE TOWNSHIP, PA 18202-9659
(866) 454-7620

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN263023
PA

Other

Enumeration date
06/14/2010
Last updated
06/14/2010
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