Individual
DR. JONATHAN BRIAN LIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 GRANDVIEW AVE STE L04, WATERBURY, CT 06708-2518
(860) 868-8932
(860) 868-7310
Mailing address
125 NEW MILFORD TPKE, NEW PRESTON MARBLE DALE, CT 06777-1703
(860) 868-8932
(860) 868-7310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
67341
CT
Other
Enumeration date
05/11/2018
Last updated
02/28/2025
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