Healthcare Provider Details

I. General information

NPI: 1295827335
Provider Name (Legal Business Name): GITA N LISKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 LAKEVILLE RD
NEW HYDE PARK NY
11042-1101
US

IV. Provider business mailing address

972 BRUSH HOLLOW RD 4TH FLOOR
WESTBURY NY
11590-1740
US

V. Phone/Fax

Practice location:
  • Phone: 516-465-5400
  • Fax: 516-465-5454
Mailing address:
  • Phone: 516-876-5555
  • Fax: 516-876-5539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number227232
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: