Provider Demographics
NPI:1144498288
Name:VOLPE, LISA (RPH)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:VOLPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 THUNDER RD
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-3139
Mailing Address - Country:US
Mailing Address - Phone:631-821-7231
Mailing Address - Fax:631-821-7263
Practice Address - Street 1:5145 NESCONSET HWY
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2047
Practice Address - Country:US
Practice Address - Phone:631-331-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041148OtherRPH STATE LICENSE NUMBER