Provider Demographics
NPI:1710925102
Name:DE PADUA, LIZBETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZBETH
Middle Name:S
Last Name:DE PADUA
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 1:1417 EIGHTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:484-526-5210
Mailing Address - Fax:484-526-5237
Practice Address - Street 1:1417 EIGHTH AVENUE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:484-526-5210
Practice Address - Fax:484-526-5237
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1034182084N0400X
PAMD036124E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology