Individual provider · Type 1 NPI

Lisa Siracusa, RPA

Surgical Physician Assistant · Staten Island, NY

NPI number 1104072909 Active

Practice location

305 Seguine Ave, Suite Two
Staten Island, NY 10309-3730

Call (718) 966-7009 Map

Fax (718) 948-7514

Other practice locations

  • 81 Veronica Ave Ste 205, Somerset, NJ 08873-3491 · (732) 640-5316

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X004641 (NY)
Surgical Physician Assistant Primary 363AS0400X25MP00315900 (NJ)

Surgical Physician Assistant: Definition to come...

13 other providers at this address

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About NPI 1104072909

Lisa Siracusa, RPA's National Provider Identifier is 1104072909, issued on Aug 12, 2008. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Staten Island, NY. The record was last updated on Jan 29, 2026.