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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639169618 NPPES
Massachusetts MEDICAID 3060284
Massachusetts Other J09499
Massachusetts Other 60264
Massachusetts Other 755370

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