Provider Demographics
NPI:1528047313
Name:TREUSCH, LISA ANN (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:TREUSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5165 IMPERIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9523
Mailing Address - Country:US
Mailing Address - Phone:814-774-3128
Mailing Address - Fax:814-774-0915
Practice Address - Street 1:5165 IMPERIAL PKWY
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-9523
Practice Address - Country:US
Practice Address - Phone:814-774-3128
Practice Address - Fax:814-774-0915
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053810L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G06225Medicare UPIN