Provider Demographics
NPI:1932307832
Name:JAGER, LISA NICOLE PFEFFER (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:NICOLE PFEFFER
Last Name:JAGER
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 1:10000 FALLS RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4103
Mailing Address - Country:US
Mailing Address - Phone:301-983-5103
Mailing Address - Fax:
Practice Address - Street 1:10000 FALLS RD
Practice Address - Street 2:SUITE 208
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4103
Practice Address - Country:US
Practice Address - Phone:301-983-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00660992084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry