Healthcare Provider Details

I. General information

NPI: 1528039773
Provider Name (Legal Business Name): STEVEN P LISSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 OAK HILL RD
RED BANK NJ
07701-5727
US

IV. Provider business mailing address

80 OAK HILL RD
RED BANK NJ
07701-5727
US

V. Phone/Fax

Practice location:
  • Phone: 732-741-2313
  • Fax: 732-741-1952
Mailing address:
  • Phone: 732-741-2313
  • Fax: 732-741-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA06025200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA06025200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number25MA06025200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: