Provider Demographics
NPI:1942275847
Name:ROSSELL-SEED, LISA ANN (DO)
Entity Type:Individual
Prefix:
First Name:LISA ANN
Middle Name:
Last Name:ROSSELL-SEED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:623 E BROAD ST
Mailing Address - Street 2:2ND FLR
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6332
Mailing Address - Country:US
Mailing Address - Phone:610-954-6048
Mailing Address - Fax:610-954-3189
Practice Address - Street 1:5828 OLD BETHLEHEM PIKE
Practice Address - Street 2:SUITE # 307
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9484
Practice Address - Country:US
Practice Address - Phone:610-282-2155
Practice Address - Fax:610-282-2350
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS011952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018871360003Medicaid
PA0018871360003Medicaid
PAH55978Medicare UPIN