Provider Demographics
NPI:1659310159
Name:SCHAFFER, LISA J (DO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4623 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4542
Mailing Address - Country:US
Mailing Address - Phone:215-474-6100
Mailing Address - Fax:215-747-6123
Practice Address - Street 1:4623 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-4542
Practice Address - Country:US
Practice Address - Phone:215-474-6100
Practice Address - Fax:215-474-6123
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS011957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine