Provider Demographics
NPI:1871512988
Name:HOLLANDER, LISA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7012 WALLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1711
Mailing Address - Country:US
Mailing Address - Phone:410-602-2777
Mailing Address - Fax:410-602-1244
Practice Address - Street 1:3635 OLD COURT RD
Practice Address - Street 2:SUITE 408
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3915
Practice Address - Country:US
Practice Address - Phone:410-602-2777
Practice Address - Fax:410-602-1244
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD394202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD198911100Medicaid
MDE61266Medicare UPIN
MD198911100Medicaid