Organization
XL-MED PC
Active
Organization
XL-MED PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA LISHKO M.D. (PRESIDENT)
(201) 475-1005
Entity
Organization
Contact information
Practice address
25-15 FAIR LAWN AVE, FAIR LAWN, NJ 07410-3434
(201) 475-1005
(201) 475-1009
Mailing address
17-17 GREENWOOD DR, FAIR LAWN, NJ 07410-4533
(201) 475-1005
(201) 475-1009
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MA67105
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8503702
—
NJ
Enumeration date
02/13/2007
Last updated
08/22/2020
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