Most Relevant Information
Provider Data
| NPI Number: | 1003385352 |
| Provider Name: | LISA TRENTINO PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 022979 |
Most Important Dates
| Enumeration Date: | 11/15/2018 |
| Last Updated: | 02/20/2019 |
Provider Practice Location
2500 NESCONSET HWY BLDG 15H
STONY BROOK
NY
11790
Practice Location Phone/Fax
| Phone: | 6316893005 |
| Fax: |
Provider Mailing Location
2500 NESCONSET HWY BLDG 15H
STONY BROOK
NY
117902554
Provider Mailing Phone/Fax
| Phone: | 6316893005 |
| Fax: |