Provider Demographics
NPI:1417935818
Name:HOWARD, LISA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANNE
Last Name:HOWARD
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 1:25 BOND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3401
Mailing Address - Country:US
Mailing Address - Phone:413-582-3027
Mailing Address - Fax:413-582-3098
Practice Address - Street 1:25 BOND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3401
Practice Address - Country:US
Practice Address - Phone:413-582-3027
Practice Address - Fax:413-582-3098
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219908207Q00000X, 207R00000X
CT041937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG11039Medicare UPIN