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General NPI Number Information
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NPI Number | 1699163139
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Entity Type | Organization
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Legal Business Name | M LISKER ACUPUNCTURE PC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 1957 CONEY ISLAND AVE YOGA PLACE
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City | BROOKLYN
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State | NY
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Zip | 11223-2328
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Country | US
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Telephone | 917-406-3128
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Fax | 718-715-1437
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Provider Business Mailing Address
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Address Line | 2730 E 21ST ST
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City | BROOKLYN
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State | NY
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Zip | 11235-2913
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Country | US
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Telephone | 917-406-3128
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL LISKER
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Credential | L.AC.
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Telephone | 917-406-3128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 001735-1
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License Number State | NY
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