Individual
JEFFREY LAWRENCE LISIECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
737 PARK AVE APT 1C, NEW YORK, NY 10021-4264
(212) 680-4626
Mailing address
737 PARK AVE APT 1C, NEW YORK, NY 10021-4264
(212) 680-4626
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
314856
NY
208200000X
Plastic Surgery Physician
S9341
TX
390200000X
Student in an Organized Health Care Education/Training Program
4301107909
MI
Other
Enumeration date
06/08/2015
Last updated
07/28/2022
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