Healthcare Provider Details

I. General information

NPI: 1548351679
Provider Name (Legal Business Name): LISA ELLEN ARBESFELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 BEDFORD ST STE 211
LEXINGTON MA
02420
US

IV. Provider business mailing address

57 BEDFORD ST STE 211
LEXINGTON MA
02420
US

V. Phone/Fax

Practice location:
  • Phone: 781-862-2322
  • Fax: 781-863-0927
Mailing address:
  • Phone: 781-862-2322
  • Fax: 781-863-0927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number75780
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: