Liskov, David

Liskov, David is an individual health care provider with primary practice located at 562 Wyoming Ave , Kingston PA 18704-3721. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Liskov, David can be contacted via phone (570) 552-3900.

Contact Information

Primary practice address
562 Wyoming Ave Kingston PA 18704-3721
Phone: (570) 552-3900
Fax: (570) 287-6733
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X MD-034887-E Pennsylvania

Profile Details

NPI number 1780683417
LBN Legal business name Liskov, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2005
Last updated May 29th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780683417 NPPES
Pennsylvania MEDICAID 0010825390002
Pennsylvania MEDICAID 0010825390003

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