Individual
CHANA DEVORA LISSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14449 72ND RD, FLUSHING, NY 11367-2405
(301) 908-3388
Mailing address
643 HICKSVILLE RD, FAR ROCKAWAY, NY 11691-5220
(301) 908-3388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024523
NY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/13/2019
Last updated
04/08/2025
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