Lisciandro, Kelly Anne
Lisciandro, Kelly Anne is an sole proprietor health care provider with primary practice located at 6720 Pittsford Palmyra Road Ste 15, Fairport NY 14450. 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
6720 Pittsford Palmyra Road Ste 15
Fairport NY 14450
Phone: (585) 364-0025
Fax: (585) 364-0024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 228369-1 | 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 | May 14th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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