Individual
LISA J. EASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
561 HAWTHORNE AVE, PHILADELPHIA, PA 19128
(215) 487-4000
Mailing address
7600 STENTON AVE, APT 10-E, PHILADELPHIA, PA 19118-3231
(215) 247-3110
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA023373L
PA
Other
Enumeration date
02/26/2009
Last updated
03/03/2009
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