DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. LISA L PARK, MD

Active

DR. LISA L PARK, MD is a Adolescent Medicine (Pediatrics) healthcare provider located in FAIRFAX, Virginia. NPI 1699982868 is currently active in the NPPES registry. Verify at CMS.

Adolescent Medicine (Pediatrics) · FAIRFAX, VA

Registration Details

NPI Number
1699982868
Provider Type
Individual
Gender
Female
NPI Issued
May 17, 2007 (19.214318059966 yrs)
Last Updated
Jan 11, 2012
Licenses
0101250887 (VA)
25MA08646300 (NJ)

Practice Information

Address
4400 UNIVERSITY DR
STUDENT UNION BUILDING 1, ROOM 2300
FAIRFAX, VA, 220304422
Browse VA providers · Browse ZIP 22030
Phone
7039932831
Fax
7039934365
Primary Specialty
Adolescent Medicine (Pediatrics)
2080A0000X

Other Adolescent Medicine (Pediatrics) Providers in FAIRFAX, VA

Name Credential NPI
DR. JOHN T TSAI M.D. 1376527366
DR. WAGIDA A ABDALLA M.D. 1578582748
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.