Provider Demographics
NPI:1588704738
Name:BLECKNER, LISA L (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:L
Last Name:BLECKNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 WRAMC ROOM 2J38
Mailing Address - Street 2:6900 GEORGIA AVE. NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-0001
Mailing Address - Country:US
Mailing Address - Phone:202-782-7327
Mailing Address - Fax:
Practice Address - Street 1:2 WRAMC RM 2J38
Practice Address - Street 2:6900 GEORGIA AVE. NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-7327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDDOO54687207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology