Healthcare Provider Details

I. General information

NPI: 1588585186
Provider Name (Legal Business Name): LISBETH ANN KOSIUR BARAJIKIAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BLOOMINGDALE RD
WHITE PLAINS NY
10605-1504
US

IV. Provider business mailing address

42 RIVERVIEW AVE
TARRYTOWN NY
10591-4416
US

V. Phone/Fax

Practice location:
  • Phone: 914-682-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number360528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: