Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | UP006911C | PA |
NPI | 1336143254 |
---|---|
Provider Name | Mrs. Lisa K Albert |
First Address | Lower Gwynedd, PA 19002-2655 |
Second Address | Lower Gwynedd, PA 19002-2655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 10/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P68859 | (02) | PA |