Antonelli, Lisa F
Antonelli, Lisa F is an individual health care provider with primary practice located at 2100 Dorchester Avenue Smg - Carney Hospital, Dorchester MA 02124. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Antonelli, Lisa F can be contacted via phone (617) 296-4000.Contact Information
Primary practice address
2100 Dorchester Avenue Smg - Carney Hospital
Dorchester MA 02124
Phone: (617) 296-4000
Fax: (617) 474-3860
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 72272 | Massachusetts |
Profile Details
NPI number | 1639169618 |
---|---|
LBN Legal business name | Antonelli, Lisa F |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 21st, 2005 |
Last updated | Nov 4th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639169618 | NPPES |
Massachusetts | MEDICAID | 3060284 | |
Massachusetts | Other | J09499 | |
Massachusetts | Other | 60264 | |
Massachusetts | Other | 755370 |
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