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Individual

DR. LISA PEDEVILLANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9501 ROOSEVELT BLVD STE 312, PHILADELPHIA, PA 19114-1028
(215) 331-7001
(215) 331-7004
Mailing address
1430 W SHERMAN AVE, VINELAND, NJ 08360-6927
(845) 797-5195

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
OS023186
PA

Other

Enumeration date
04/29/2016
Last updated
10/31/2023
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