Provider Demographics
NPI:1225228323
Name:HIRSCHHORN, LISA R (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:HIRSCHHORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2404
Mailing Address - Country:US
Mailing Address - Phone:617-482-9485
Mailing Address - Fax:
Practice Address - Street 1:JSI RESEARCH & TRAINING
Practice Address - Street 2:44 FARNSWORTH STREET
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210
Practice Address - Country:US
Practice Address - Phone:617-482-9485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59432207RI0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical & Laboratory Immunology