Lizogubenko, Igor

Lizogubenko, Igor is an individual health care provider with primary practice located at 200 Belle Terre Rd , Port Jefferson NY 11777-1928. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lizogubenko, Igor can be contacted via phone (631) 474-6000.

Contact Information

Primary practice address
200 Belle Terre Rd Port Jefferson NY 11777-1928
Phone: (631) 474-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 008125-1 New York

Profile Details

NPI number 1033163035
LBN Legal business name Lizogubenko, Igor
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Jan 16th, 2008 - about 18 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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