Individual
DR. LIBRADA L LISING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 PENNINGTON AVE, PASSAIC, NJ 07055-4617
(973) 470-3000
(973) 470-3506
Mailing address
15 WINDSOR CT, FAIRFIELD, NJ 07004-1228
(973) 885-8669
(973) 470-3506
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
25MA03038200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6641806
—
NJ
Enumeration date
10/23/2006
Last updated
07/08/2007
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