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Individual
DR. KENNETH A LISS
Active
Individual
DR. KENNETH A LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MB06380300
NJ
246ZN0300X
Nephrology Specialist/Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7014902
—
NJ
Enumeration date
07/31/2006
Last updated
03/08/2024
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