Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MD063118L | PA |
NPI | 1073571626 |
---|---|
Provider Name | Dr. Lisa Beth Freedman |
First Address | Villanova, PA 19085-1818 |
Second Address | Villanova, PA 19085-1818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 20/03/2014 |