Debernardi, Lisa A

Debernardi, Lisa A is an sole proprietor health care provider with primary practice located at 5108 Hampton Ave , Saint Louis MO 63109-3113. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is her primary health care specialty. Debernardi, Lisa A can be contacted via phone (314) 821-3668.

Contact Information

Primary practice address
5108 Hampton Ave Saint Louis MO 63109-3113
Phone: (314) 821-3668
Fax: (888) 966-0079
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004789 Illinois
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 2008030512 Missouri

Profile Details

NPI number 1043219215
LBN Legal business name Debernardi, Lisa A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2005
Last updated Dec 21st, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043219215 NPPES
Illinois MEDICAID 016004789
Illinois MEDICAID 1043219215
Illinois Other 1622982
Illinois Other 480014516
Illinois Other P01302982

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