Provider Demographics
NPI:1356375711
Name:NOCERA, LISA M (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:NOCERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-7037
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1 W ELM ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428
Practice Address - Country:US
Practice Address - Phone:610-567-5141
Practice Address - Fax:610-567-6955
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048125L207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015315000005Medicaid
PA32888OtherHEALTH PARTNERS PAIN MGT
PA777936OtherPERSONAL CHOICE
PA0802863000OtherKEYSTONE
PA777936OtherHIGHMARK BLUE SHIELD
PA01697OtherHEALTH PARTNERS
PA1336745OtherUNITED HEALTHCARE
PA3056444OtherAETNA CONTRACT
PA30567OtherHEALTH PARTNERS FRANKFORD
PA0015315000004Medicaid
PA0015315000007Medicaid
PA30030914OtherKEYSTONE MERCY
PA0015315000006Medicaid
PA01697OtherHEALTH PARTNERS
PA1336745OtherUNITED HEALTHCARE