Provider Demographics
NPI:1316008659
Name:CARCHEDI, LISA ROSINA (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ROSINA
Last Name:CARCHEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 S UNION AVE
Mailing Address - Street 2:DEPT OF BEHAVIORAL HEALTH
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3409
Mailing Address - Country:US
Mailing Address - Phone:443-843-8050
Mailing Address - Fax:443-843-6088
Practice Address - Street 1:501 S UNION AVE
Practice Address - Street 2:DEPT OF BEHAVIORAL HEALTH
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3409
Practice Address - Country:US
Practice Address - Phone:443-843-8050
Practice Address - Fax:443-843-6088
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00802682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AB515OtherBCBS
TX208915301Medicaid
TX8L8030Medicare PIN