Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Lisa Ann Vicencio, ATC

Individual provider Athletic Trainer · NPI 1235775768

Mrs. Lisa Ann Vicencio, ATC is an Athletic Trainer in Plattsburgh, New York. Licensed in New York. Registered with an NPI since 2019.

Licensed in
NY
In the registry since
2019
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

101 Broad St
Plattsburgh, NY 12901-2637
Phone: (518) 564-4152
Fax: (518) 564-2558
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 000682-1 (NY)

Record details

NPI number1235775768
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC
Sole proprietorNo
NPI enumeratedNovember 19, 2019
Last updated in NPPESNovember 19, 2019

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