Individual
DR. JORDAN M LISELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1367 WASHINGTON AVE STE 200, ALBANY, NY 12206-1043
(518) 489-2666
(518) 489-5933
Mailing address
1367 WASHINGTON AVE, SUITE 200, ALBANY, NY 12206-1069
(518) 489-2666
(518) 489-5933
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
4301087211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02865736
—
NY
Enumeration date
04/19/2006
Last updated
01/09/2026
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