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Contact Information

LISA PACIFICO, PT
44 MARITIME DIVE
MYSTIC, CT06355
 Phone: 860-572-1700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LISA PACIFICO · (Female)

NPI Number 1417351156
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 10/09/2014
Last updated 10/09/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 007696
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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