Healthcare Provider Details

I. General information

NPI: 1457748410
Provider Name (Legal Business Name): IRINA LISKER WEIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S LIVINGSTON AVE STE 104
LIVINGSTON NJ
07039-3033
US

IV. Provider business mailing address

20M NOBHILL
ROSELAND NJ
07068-3811
US

V. Phone/Fax

Practice location:
  • Phone: 973-847-2735
  • Fax: 973-524-7613
Mailing address:
  • Phone: 973-847-2735
  • Fax: 973-524-7613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA09963900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: