Individual
DR. TIMOTHY STEPHEN LISHNAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-8770
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-8770
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042.0012118
VT
207QS0010X
Sports Medicine (Family Medicine) Physician
042.0012118
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174725303
NPI
—
05
—
1174725303
—
CT
Enumeration date
06/01/2007
Last updated
07/01/2016
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