Individual
LISE RICOTTA ASARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 S PACA ST, SUITE 300 6TH FL, BALTIMORE, MD 21201-1642
(410) 328-6720
(410) 328-1674
Mailing address
PO BOX 64374, BALTIMORE, MD 21264-4374
(410) 328-6720
(410) 328-1674
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0067606
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415168200
—
MD
01
—
P00771790
MEDICARE RAILROAD
MD
Enumeration date
02/07/2007
Last updated
02/05/2010
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