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DR. LISA L PARK MD
NPI 1699982868
Pediatrics - Adolescent Medicine in Fairfax, VA

Active since May 17, 2007
4400 UNIVERSITY DR, STUDENT UNION BUILDING 1, ROOM 2300, FAIRFAX, VA 22030(703) 993-2831(703) 993-4365 Get Directions Write a Review

NPPES record last updated: January 11, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Lisa L Park Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA L PARK MD (NPI 1699982868) is an individual adolescent medicine provider in Fairfax, Virginia, licensed in Virginia (0101250887) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1699982868
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameDR. LISA L PARKCredential: MD
Location Address4400 UNIVERSITY DR, STUDENT UNION BUILDING 1, ROOM 2300Fairfax, VA 22030-4422
Mailing Address4400 University Dr, Student Union Building 1, Room 2300Fairfax, VA 22030-4422 · (703) 993-2831 · Fax (703) 993-4365
Phone(703) 993-2831
Fax(703) 993-4365
Sole ProprietorNo
Enumeration DateMay 17, 2007
Last NPPES UpdateJanuary 11, 2012
✔ NPI 1699982868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Licenses✔ Licensed in VA · 0101250887✔ Licensed in NJ · 25MA08646300
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
4400 UNIVERSITY DR, Fairfax, VA 22030
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRIYA PATEL
Student in an Organized Health Care Education/Training Program
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (954) 288-2932
LATIFA BENSOUIDI
Student in an Organized Health Care Education/Training Program
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (703) 993-1000
MS. ROCIO RODRIGUEZ
Social Worker
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (210) 288-5957
DR. OLYMPIA P DALLAS MD
Specialist
4400 UNIVERSITY DR, MS 2D3 GEORGE MASON UNIVERSITY STUDENT HEALTH
FAIRFAX, VA 22030
Fairfax City (703) 993-2807
VINH NGUYEN KIEU PHARMD, BCACP
Pharmacist
4400 UNIVERSITY DR, MSN 3C4
FAIRFAX, VA 22030
Fairfax City (703) 993-1946
ALI AHMAD
Specialist/Technologist (Athletic Trainer)
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (703) 303-1311
CHERYL HAIRSTON ATC
Specialist/Technologist (Athletic Trainer)
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (703) 993-3277
ANGELIKA KIA VARGAS
Respiratory Therapist, Certified
4400 UNIVERSITY DR
FAIRFAX, VA 22030
Fairfax City (305) 781-8375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Park's NPI number?

The NPI number for Lisa Park is 1699982868. It was assigned to this individual provider in the NPPES registry on May 17, 2007.

Where is Lisa Park located?

Lisa Park practices at 4400 University Dr Student Union Building 1, Room 2300, Fairfax, VA 22030. The listed phone number is (703) 993-2831.

What is Lisa Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Lisa Park was last updated on January 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.