Benedetto, Lisa M

Benedetto, Lisa M is an individual health care provider with primary practice located at 132 Indian Creek Rd , Ithaca NY 14850-1331. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Benedetto, Lisa M can be contacted via phone (607) 379-9606.

Contact Information

Primary practice address
132 Indian Creek Rd Ithaca NY 14850-1331
Phone: (607) 379-9606
Fax: (607) 821-4374
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 171868 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 13010 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X F00149-1 New York

Profile Details

NPI number 1386968899
LBN Legal business name Benedetto, Lisa M
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2010
Last updated May 16th, 2020 - about 6 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 1386968899 NPPES
Colorado MEDICAID 26371243

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