Provider Demographics
NPI:1396188223
Name:JONES-KOLISKI, LISA E (RN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:E
Last Name:JONES-KOLISKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 N TITMUS DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-1522
Mailing Address - Country:US
Mailing Address - Phone:631-399-6969
Mailing Address - Fax:
Practice Address - Street 1:262 N TITMUS DR
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-1522
Practice Address - Country:US
Practice Address - Phone:631-399-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY507861163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care