Individual
DR. JONATHAN MARTIN LISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1133 BROADWAY, SUITE 721, NEW YORK, NY 10010-7903
(917) 647-4270
Mailing address
1133 BROADWAY, SUITE 721, NEW YORK, NY 10010-7903
(917) 647-4270
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017752
NY
Other
Enumeration date
09/24/2008
Last updated
05/08/2017
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