| Doctor Name: | TARA LISKOV |
| NPI Number: | 1245231802 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. |
| License Number: | 000358 |
| Business Practice Address: | 999 Silver Ln Suite 2a Trumbull, CT - 066115343 |
| Business Phone Number: | 2033860044 |
| Business Fax Number: | 2033774156 |
| Mailing Address: | 999 Silver Ln, Suite 2a TRUMBULL |
| State: | CT |
| Postal Code: | 066115343 |
| Phone Number: | 2033860044 |
| Fax Number: | 2033774156 |
| NPI Enumeration Date: | 08/04/2005 |
| NPI Last Update Date: | 07/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 000358 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |