Provider Demographics
NPI:1114926763
Name:SKLAR, LISA FRAMM (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:FRAMM
Last Name:SKLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:302 MAPLE AVE W
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5613
Mailing Address - Country:US
Mailing Address - Phone:703-938-1201
Mailing Address - Fax:703-938-3563
Practice Address - Street 1:302 MAPLE AVE W
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5613
Practice Address - Country:US
Practice Address - Phone:703-938-1201
Practice Address - Fax:703-938-3563
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101043512OtherLICENSE
VA0101043512OtherLICENSE
E71112Medicare UPIN
FR-124181Medicare ID - Type Unspecified