Provider Demographics
NPI:1023613841
Name:MARTIN, LISA MARIA (RPH)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:MARIA
Other - Last Name:FERKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:265 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-9778
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1456 FERRY RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:215-340-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041355L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist