Individual
MS. ELLEN BETH LISKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, MPH, CDE
Contact information
Practice address
20 YORK ST, CBB 52, NEW HAVEN, CT 06510-3220
(203) 688-2422
(203) 688-2141
Mailing address
28 PLYMOUTH CT, MILFORD, CT 06460-3448
(203) 783-1387
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000489
CT
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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