| Lisik-roberti Clinical Medicine Llc | |
|
67 Walnut Ave Ste 402 Clark NJ 07066-1687 | |
| (732) 499-9110 | |
| (855) 822-3223 |
| Full Name | Lisik-roberti Clinical Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 67 Walnut Ave Ste 402, Clark, New Jersey |
| Authorized Official Name and Position | Chantal Lisik (OWNER/PROVIDER) |
| Authorized Official Contact | 9088686669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisik-roberti Clinical Medicine Llc 67 Walnut Ave Ste 402 Clark NJ 07066-1687 Ph: (732) 499-9110 | Lisik-roberti Clinical Medicine Llc 67 Walnut Ave Ste 402 Clark NJ 07066-1687 Ph: (732) 499-9110 |
| NPI Number | 1316401516 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 04/26/2021 |
| Medicare PECOS PAC ID | 1355675919 |
|---|---|
| Medicare Enrollment ID | O20190702000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316401516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chantal M Lisik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275845729 PECOS PAC ID: 3870749203 Enrollment ID: I20120817000139 |
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