Menillo, Lisa
Menillo, Lisa is an individual health care provider with primary practice located at 1301 Farmington Ave , Bristol CT 06010-4776. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Menillo, Lisa can be contacted via phone (860) 589-4501.Contact Information
Primary practice address
1301 Farmington Ave
Bristol CT 06010-4776
Phone: (860) 589-4501
Fax: (860) 589-4502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 030842 | Connecticut |
Profile Details
| NPI number | 1952309924 |
|---|---|
| LBN Legal business name | Menillo, Lisa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Oct 8th, 2020 - about 4 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 | 1952309924 | NPPES |
| Connecticut | MEDICAID | 001308429 |
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