Individual
LISA WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-1000
(215) 590-3992
Mailing address
100 PENN SQUARE EAST, 9TH FLOOR NORTH TOWER, PHILADELPHIA, PA 19107
(267) 425-9200
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD435075
PA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD435075
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027194410004
—
PA
Enumeration date
06/06/2007
Last updated
12/04/2018
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