Provider Demographics
NPI:1073559316
Name:BLOCK, LISA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2560
Mailing Address - Fax:717-812-2569
Practice Address - Street 1:781 FAR HILLS DR
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-9346
Practice Address - Country:US
Practice Address - Phone:717-812-2560
Practice Address - Fax:717-812-2569
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4213732084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA243879OtherVALUE OPTIONS
PA3107334OtherMAMSI
PA1459504OtherPA BLUE SHIELD
PA01950285Medicaid
PAP00031247OtherMEDICARE RAILROAD
PA50009524OtherCAPITAL BLUE CROSS
PA1056692OtherCIGNA BEHAVIORAL HEALTH
PA132296000OtherMAGELLAN
PA619012OtherBC/BS OF MD CARE FIRST
PA3107334OtherMAMSI
PAE46660Medicare UPIN