Healthcare Provider Details
I. General information
NPI: 1013331735
Provider Name (Legal Business Name): ADRIANA LISINSCHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/17/2014
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 CROSSING BLVD SUITE ONE
HALFMOON NY
12065-4154
US
IV. Provider business mailing address
3 CROSSING BLVD SUITE ONE
HALFMOON NY
12065-4154
US
V. Phone/Fax
- Phone: 518-831-4434
- Fax: 518-831-4435
- Phone: 518-831-4434
- Fax: 518-831-4435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 275531 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: