MEDICARE: DR. JAY J LISKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	227230	NY

General Provider Information

NPI Number	:	1457397861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY J LISKER MD

Provider Business Mailing Address
First Line	:	225 COMMUNITY DR
Second Line	:	SUITE 130
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5506
Country	:	US
Telephone Number	:	516-504-0474
Fax Number	:	516-504-0477

Provider Business Practice Location Address
First Line	:	225 COMMUNITY DR
Second Line	:	SUITE 130
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5506
Country	:	US
Telephone Number	:	516-504-0474
Fax Number	:	516-504-0477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	01/17/2011

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Directions to “ DR. JAY J LISKER MD” Practice Location

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