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Individual
LISA A THAYER
Active
Individual
LISA A THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
155172
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015185
NEIGHBORHOOD HEALTH
MA
01
—
155172
TUFTS
MA
05
—
3189732
—
MA
01
—
J19137
BLUE CROSS
MA
01
—
PP820
HARVARD PILGRIM
MA
Enumeration date
01/23/2006
Last updated
03/08/2021
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