MEDICARE: LISA E KNOFLICEK 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	MD426771	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	:	1720184807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA E KNOFLICEK MD

Provider Business Mailing Address
First Line	:	1233 LOCUST ST FL 3
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5400
Country	:	US
Telephone Number	:	215-985-4448
Fax Number	:	215-985-4952

Provider Business Practice Location Address
First Line	:	1207 CHESTNUT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4131
Country	:	US
Telephone Number	:	215-525-8600
Fax Number	:	215-567-1012

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	12/10/2025

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Directions to “ LISA E KNOFLICEK MD” Practice Location

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