Individual
MRS. LISA A CAPOGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007291
CT
225100000X
Physical Therapist
16550
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468109
TUFTS
MA
01
—
Y68287
BCBS
MA
Enumeration date
06/11/2006
Last updated
06/01/2010
Update your record
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