Provider Demographics
NPI:1689817181
Name:PAPPAS-TAFFER, LISA KIMBERLY (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KIMBERLY
Last Name:PAPPAS-TAFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KIMBERLY
Other - Last Name:PAPPAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 CIVIC CENTER BLVD.
Mailing Address - Street 2:1-330S PERELMAN CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2737
Mailing Address - Fax:215-615-3424
Practice Address - Street 1:3400 CIVIC CENTER BLVD.
Practice Address - Street 2:1-330S PERELMAN CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-2737
Practice Address - Fax:215-615-3424
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445060207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology