Provider Demographics
NPI:1649289596
Name:LISBIN, PING JAIN (LAC)
Entity type:Individual
Prefix:MRS
First Name:PING
Middle Name:JAIN
Last Name:LISBIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WEST LANCASTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2416
Mailing Address - Country:US
Mailing Address - Phone:610-796-2684
Mailing Address - Fax:
Practice Address - Street 1:300 WEST LANCASTER AVENUE
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2416
Practice Address - Country:US
Practice Address - Phone:610-775-7565
Practice Address - Fax:610-775-8442
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000185171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist