Individual
LISA MOFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PA0EG000769
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000027186
MEDICARE
PA
01
—
001746361 0003
PA DEPT OF HUMAN SERVICES
PA
01
—
0017463610003
PROMISE WELFARE
—
01
—
376852
BCBS
—
01
—
52269
DAVIS
—
Enumeration date
08/01/2006
Last updated
12/01/2016
Update your record
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