Provider Demographics
NPI:1972555340
Name:DR HARVEY N LISGAR & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR HARVEY N LISGAR & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:LISGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-364-4141
Mailing Address - Street 1:95 ALMSHOUSE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1154
Mailing Address - Country:US
Mailing Address - Phone:215-364-4141
Mailing Address - Fax:215-364-7162
Practice Address - Street 1:95 ALMSHOUSE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1154
Practice Address - Country:US
Practice Address - Phone:215-364-4141
Practice Address - Fax:215-364-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0650847Medicaid
149762Medicare ID - Type Unspecified