Individual
IZOLDA LISHANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2301 E ALLEGHENY AVE, SUITE 150, PHILADELPHIA, PA 19134-4427
(215) 677-1475
(215) 677-3082
Mailing address
PO BOX 820933, PHILADELPHIA, PA 19182-0933
(215) 677-1475
(215) 677-3082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD37461E
PA
207Q00000X
Family Medicine Physician
Primary
MD037461E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011979300001
—
PA
01
—
1007278000
TPI MEDICAID GROUP
PA
01
—
597586
TPI MEDICARE GROUP
PA
01
—
CD4829
TPI RAILROAD MEDICARE GROUP
PA
Enumeration date
07/31/2006
Last updated
11/20/2013
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