MEDICARE: LISA B YARNOFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD049925L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972502086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA B YARNOFF MD

Provider Business Mailing Address
First Line	:	1240 S BROAD ST STE 130
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-5395
Country	:	US
Telephone Number	:	215-361-5040
Fax Number	:	215-393-5441

Provider Business Practice Location Address
First Line	:	1240 S BROAD ST STE 130
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-5395
Country	:	US
Telephone Number	:	215-361-5040
Fax Number	:	215-393-5441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/17/2018

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Directions to “ LISA B YARNOFF MD” Practice Location

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