Organization
DAVID LISKOV, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LISKOV MD (OWNER)
(570) 287-2900
Entity
Organization
Contact information
Practice address
562 WYOMING AVE, KINGSTON, PA 18704-3721
(570) 552-3900
(570) 300-1829
Mailing address
512 NORTHAMPTON ST, EDWARDSVILLE, PA 18704-4560
(570) 287-2900
(570) 300-1829
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
MD034887E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010825390002
—
PA
Enumeration date
06/25/2009
Last updated
05/29/2013
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