Individual
DR. LISA BERGERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 335-7893
Mailing address
PO BOX 9135, ATT:SHARON SILVA, BROOKLINE, MA 02446-9135
(603) 890-4404
(603) 893-8886
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
160372
MA
208000000X
Pediatrics Physician
160372
MA
2080P0202X
Pediatric Cardiology Physician
Primary
160372
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039290
—
MA
01
—
2501928
UNITED HEALTHCARE MA
MA
01
—
28244
BMC HEALTHNET
MA
01
—
468809
TUFTS HEALTH PLAN
MA
01
—
96969201
NETWORK HEALTH
MA
01
—
J27337
HMO BLUE
MA
05
—
LB54040
—
RI
Enumeration date
10/14/2005
Last updated
11/21/2020
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