Individual provider · Type 1 NPI

Sean Ervin Lisk, PA-C

Medical Physician Assistant · New Haven, CT

NPI number 1104252972 Active

Practice location

20 York St
New Haven, CT 06510-3220

Call (203) 688-2615 Map

Mailing address

191 Spring St
South Salem, NY 10590-1615

Other practice locations

  • 22 Bramhall St, Portland, ME 04102-3134 · (207) 662-2414

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA1495 (ME)
Medical Physician Assistant Primary 363AM0700X3811 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1104252972

Sean Ervin Lisk, PA-C's National Provider Identifier is 1104252972, issued on Sep 24, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New Haven, CT. The record was last updated on Dec 28, 2021.