Individual
JOSEPH W LISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Contact information
Practice address
1515 BRIDGE ST, NEW CUMBERLAND, PA 17070-1120
(717) 695-4084
(717) 695-3963
Mailing address
7 DOCK HILL ROAD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002490L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
575011F6K
MEDICARE
PA
Enumeration date
09/23/2005
Last updated
07/26/2017
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