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General NPI Number Information
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NPI Number | 1689645962
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Entity Type | Individual
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Provider Name | JOAN KAREN LIESER M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 1 WOODBRIDGE CTR SUITE 400
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1150
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Country | US
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Telephone | 732-636-6622
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Fax | 732-636-3669
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Provider Business Mailing Address
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Address Line | 1 WOODBRIDGE CTR SUITE 400
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1150
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Country | US
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Telephone | 732-636-6622
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Fax | 732-636-3669
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MA51953
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA05195300
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License Number State | NJ
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