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Individual

DR. LISA ANDREA BEVILACQUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-6900
(215) 728-2773
Mailing address
3500 N BROAD ST # 1A, PHILADELPHIA, PA 19140-4106
(215) 707-2433

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD471343
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD471343
PA

Other

Enumeration date
04/16/2018
Last updated
07/28/2025
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