Brengola, Lisa Dondero
Brengola, Lisa Dondero is an individual health care provider with primary practice located at 425 Revere St , Revere MA 02151-4543. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Brengola, Lisa Dondero can be contacted via phone (781) 286-1313.Contact Information
Primary practice address
425 Revere St
Revere MA 02151-4543
Phone: (781) 286-1313
Fax: (781) 286-1098
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 215851 | Massachusetts |
Profile Details
NPI number | 1841289212 |
---|---|
LBN Legal business name | Brengola, Lisa Dondero |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 19th, 2005 |
Last updated | Apr 4th, 2013 - about 12 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 | 1841289212 | NPPES |
Massachusetts | MEDICAID | 0338290 |
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