Individual
DR. LISA LACARRUBBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(866) 233-6925
(410) 866-8606
Mailing address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0420010047
VT
207Q00000X
Family Medicine Physician
25MA06802900
NJ
207Q00000X
Family Medicine Physician
Primary
D0095650
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00049423
BLUE SHIELD
VT
01
—
080158933
RAILROAD MEDICARE
VT
05
—
0VN2307
—
VT
01
—
349703
MVP
VT
01
—
8000700
LADIES FIRST
VT
Enumeration date
11/01/2006
Last updated
12/27/2024
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