| David Liskov, Md | |
|
562 Wyoming Ave Kingston PA 18704-3721 | |
| (570) 552-3900 | |
| (570) 300-1829 |
| Full Name | David Liskov, Md |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 562 Wyoming Ave, Kingston, Pennsylvania |
| Authorized Official Name and Position | David Liskov (OWNER) |
| Authorized Official Contact | 5702872900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Liskov, Md 512 Northampton St Edwardsville PA 18704-4560 Ph: (570) 287-2900 | David Liskov, Md 562 Wyoming Ave Kingston PA 18704-3721 Ph: (570) 552-3900 |
| NPI Number | 1285862409 |
|---|---|
| Provider Enumeration Date | 06/25/2009 |
| Last Update Date | 05/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285862409 | NPI | - | NPPES |
| 0010825390002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | MD034887E (Pennsylvania) | Primary |
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