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Individual

DR. OLGA LISHKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

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
207R00000X
Internal Medicine Physician
211137
NY
207R00000X
Internal Medicine Physician
Primary
MA 67105
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8503705
NJ
Enumeration date
04/06/2006
Last updated
12/17/2009
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