Lisciandro, Kelly Anne

Lisciandro, Kelly Anne is an sole proprietor health care provider with primary practice located at 481 Penbrooke Drive Suite 2, Penfield NY 14526. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Lisciandro, Kelly Anne can be contacted via phone (585) 364-0025.

Contact Information

Primary practice address
481 Penbrooke Drive Suite 2 Penfield NY 14526
Phone: (585) 364-0025
Fax: (585) 364-0024
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 228369-1 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 228369 New York

Profile Details

NPI number 1689674814
LBN Legal business name Lisciandro, Kelly Anne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2005
Last updated Oct 16th, 2025 - about last year

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 1689674814 NPPES
New York Other 115965BJ PREFERRED CARE
New York Other 7441491 PREFERRED CARE
New York MEDICAID 02423485 PREFERRED CARE
New York Other P010228369 PREFERRED CARE

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