Dr. Lisa Anne Antonelli
Periodontist
330 Plantation Street
Worcester
, Massachusetts 01604
Dr. Lisa Anne Antonelli
Periodontist
330 Plantation Street
Worcester
, Massachusetts 01604
(508) 753-1837
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Lisa Anne Antonelli
- 330 Plantation Street
- Worcester, MA
- Zip : 01604
- Fax : (508) 753-1837
- Phone : (508) 753-1911
Second Address
- Dr. Lisa Anne Antonelli
- 330 Plantation Street
- Worcester, MA
- Zip : 01604
- Fax : (508) 753-1837
- Phone : (508) 753-1911
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 16204 | MA |
National Provider Identifier
| NPI | 1093892390 |
|---|---|
| Provider Name | Dr. Lisa Anne Antonelli |
| First Address | Worcester, MA 01604 |
| Second Address | Worcester, MA 01604 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/11/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.