Provider Demographics
NPI:1083676431
Name:COHEN, LISA MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MICHELE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 CRANBERRY HL STE 303
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7397
Mailing Address - Country:US
Mailing Address - Phone:781-290-0057
Mailing Address - Fax:781-290-0059
Practice Address - Street 1:1 CRANBERRY HL STE 303
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7397
Practice Address - Country:US
Practice Address - Phone:781-290-0057
Practice Address - Fax:781-290-0059
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA80079207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA262265OtherFALLON COMMUNITY HEALTH
MA800887OtherHARVARD PILGRIM HEALTH CA
MA1100466OtherEVERCARE
MA690074OtherTUFTS HEALTH PLAN
MAJ30753OtherBLUE CROSS BLUE SHIELD
MA3131891Medicaid
MA3836666OtherAETNA HMO
MA262265OtherFALLON COMMUNITY HEALTH
MAF54642Medicare UPIN