LISA BRESLOW DO NPI 1710138755

NPI Information

  • NPI: 1710138755
  • Provider Name: LISA BRESLOW, DO
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 390 VINEYARD WAY BLDG 500
    SUITE 501
    WEST GROVE, PA
    ZIP 19390
  • Phone: (610) 869-0953

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NPI Details

Lisa Breslow, DO is a family medicine in West Grove, PA with 19 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Lisa Breslow, DO NPI is 1710138755. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2007

The provider's business location address is:

390 VINEYARD WAY BLDG 500
SUITE 501
WEST GROVE, PA
ZIP 19390-835
Phone: (610) 869-0953
Fax: (610) 869-5824

The NPI 1710138755 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)

The enumeration date for this NPI number is 10/8/2008 and was last updated on 3/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5101025286MICHIGANNo
2207Q00000XFamily Medicine25MB10740100NEW JERSEYNo
3207Q00000XFamily Medicine302800NEW YORKNo
4207Q00000XFamily Medicine032.0133896VERMONTNo
5207Q00000XFamily MedicineS5130TEXASNo
6207Q00000XFamily MedicineOS018188PENNSYLVANIAYes
7207Q00000XFamily Medicine2020-00363NORTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11031466770001MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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