Provider Demographics
NPI:1689688053
Name:LINDER, LISA J (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:LINDER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3501 WEST CHESTER PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073
Mailing Address - Country:US
Mailing Address - Phone:610-356-9155
Mailing Address - Fax:610-356-4853
Practice Address - Street 1:3501 WEST CHESTER PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073
Practice Address - Country:US
Practice Address - Phone:610-356-9155
Practice Address - Fax:610-356-4853
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025763E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
50467OtherAETNA
PA438011Medicare PIN
B41826Medicare UPIN
50467OtherAETNA