DR. KENNETH A LISS (NPI# 1033125315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033125315 |
| Entity Type | Individual |
| Full Name | DR. KENNETH A LISS |
| Credential | DO |
| Practice Address |
6 Industrial Way W St B Hypertension & Nephrology Assoc Eatontown NJ 07724-2268 |
| Practice Telephone | 7324601200 |
| Practice Fax Number | 7324601211 |
| Mailing Telephone | 7324601200 |
| Mailing Fax Number | 7324601211 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
25MB06380300 | NJ | Allopathic & Osteopathic Physicians |
| Y | 246ZN0300X |
Specialist/Technologist, Other Specialization: Nephrology |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 7014902 | 05 |
| Street Address |
6 INDUSTRIAL WAY W ST B HYPERTENSION & NEPHROLOGY ASSOC |
| City | EATONTOWN |
| State | NJ |
| Zip Code | 07724-2268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710952213 | Raymond Stanley Flis | Internal Medicine | 6 Industrial Way W, Suite B, Eatontown, NJ 07724-2268 | 2006-02-20 |
| 1649777459 | Timothy Paul Gitto | Counselor | 6 Industrial Way W, Eatontown, NJ 07724-2268 | 2018-04-09 |
| 1134652365 | Kim M Sweeney | Counselor | 6 Industrial Way W, Eatontown, NJ 07724-2268 | 2017-04-05 |
| 1427580513 | Melissa Scherer | Social Worker | 6 Industrial Way W, Bldg. D, Eatontown, NJ 07724-2268 | 2017-03-29 |
| 1952832958 | Jaclyn Ventre | Dietitian, Registered | 6 Industrial Way W, Eatontown, NJ 07724-2268 | 2017-03-22 |
| 1083145296 | Fatima Tobon | Social Worker | 6 Industrial Way W, Bldg D, Eatontown, NJ 07724-2268 | 2017-03-21 |
| 1487968301 | Option Care Enterprises, Inc. | Home Infusion | 6 Industrial Way W, Suite C, Eatontown, NJ 07724-2281 | 2010-08-03 |
| 1376655878 | Nikki Daskalakis | Internal Medicine | 6 Industrial Way W, Ste B Hypertension & Nephrology Assoc, Eatontown, NJ 07724 | 2006-08-31 |
| 1578593927 | Total Renal Care Inc | Clinic/Center | 6 Industrial Way W, Ste B, Eatontown, NJ 07724-2258 | 2006-07-03 |
| 1811940810 | I.v. Associates, Inc. | Home Infusion | 6 Industrial Way W, Suite C, Eatontown, NJ 07724-2268 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1649745589 | Jersey Shore Dental Spa LLC | Dentist | 613 Hope Road Building 5, Eatontown, NJ 07724 | 2018-10-08 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| Find all providers in zip 07724 | ||||
| Taxonomy Code | 246ZN0300X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Nephrology |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.