Medvetz, Lisa Ann

Medvetz, Lisa Ann is an individual health care provider with primary practice located at 1113 Hospital Dr Suite 100, Willingboro NJ 08046-1103. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Medvetz, Lisa Ann can be contacted via phone (609) 835-5821.

Contact Information

Primary practice address
1113 Hospital Dr Suite 100 Willingboro NJ 08046-1103
Phone: (609) 835-5821
Fax: (609) 835-5827
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X MD060721-L Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X 51460 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X MD060721L Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X M-13032 Idaho
Allopathic & Osteopathic Physicians / Surgery 208600000X 25MA06954000 New Jersey

Profile Details

NPI number 1467451823
LBN Legal business name Medvetz, Lisa Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Sep 1st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467451823 NPPES
Pennsylvania Other 113499 BCBS
Pennsylvania MEDICAID 0017932090008 BCBS
Pennsylvania MEDICAID 8239606 BCBS

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