Bevilacqua, Lisa R

Bevilacqua, Lisa R is an individual health care provider with primary practice located at 1882 New Scotland Rd Ste 200 , Slingerlands NY 12159-3627. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bevilacqua, Lisa R can be contacted via phone (518) 439-2460.

Contact Information

Primary practice address
1882 New Scotland Rd Ste 200 Slingerlands NY 12159-3627
Phone: (518) 439-2460
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 191889 New York

Profile Details

NPI number 1336231844
LBN Legal business name Bevilacqua, Lisa R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated May 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336231844 NPPES
New York MEDICAID 01495192
New York Other 08954
New York Other 200032
New York Other 52558
New York Other 10005959
New York Other 000401405003
New York Other 040824000041
New York Other 4725D1
New York Other 531715

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