Dr. Jordan M Lisella
Foot and Ankle Orthopaedic Surgeon
1367 Washington Ave Suite 200
Albany
, New York 12206-1069
Dr. Jordan M Lisella
Foot and Ankle Orthopaedic Surgeon
1367 Washington Ave Suite 200
Albany
, New York 12206-1069
(518) 489-5933
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About
Features
Specialties
- Foot and Ankle Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jordan M Lisella
- 1367 Washington Ave Suite 200
- Albany, NY
- Zip : 12206-1069
- Fax : (518) 489-5933
- Phone : (518) 489-2666
Second Address
- Dr. Jordan M Lisella
- 1367 Washington Ave Suite 200
- Albany, NY
- Zip : 12206-1069
- Fax : (518) 489-5933
- Phone : (518) 489-2666
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 4301087211 | MI |
National Provider Identifier
| NPI | 1720043946 |
|---|---|
| Provider Name | Dr. Jordan M Lisella |
| First Address | Albany, NY 12206-1069 |
| Second Address | Albany, NY 12206-1069 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/04/2006 |
| Last Update Date | 28/02/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02865736 | (05) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.