Provider Demographics
NPI:1598773228
Name:HALPERN, LISA RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:RACHEL
Last Name:HALPERN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:510 NIRVANA ST
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6542
Mailing Address - Country:US
Mailing Address - Phone:301-963-2396
Mailing Address - Fax:
Practice Address - Street 1:5229 NEW DESIGN RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7103
Practice Address - Country:US
Practice Address - Phone:301-668-1320
Practice Address - Fax:301-696-1390
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00456392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD950QMedicare ID - Type Unspecified