Individual
MATTHEW LISSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 E 63RD ST APT 2B, NEW YORK, NY 10021-7328
(212) 838-0707
(212) 838-6781
Mailing address
105 E 63RD ST APT 2B, NEW YORK, NY 10021-7328
(212) 838-0707
(212) 838-6781
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
230099
NY
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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