Provider Demographics
NPI:1083906119
Name:ARMSTRONG, ANNE-LISE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE-LISE
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNE-LISE
Other - Middle Name:
Other - Last Name:PAISIBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-373-4298
Mailing Address - Fax:814-724-2196
Practice Address - Street 1:991 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3344
Practice Address - Country:US
Practice Address - Phone:814-373-4298
Practice Address - Fax:814-724-2196
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451434207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029290910002Medicaid
PA1029290910002Medicaid
PA1029290910002Medicaid