Provider Demographics
NPI:1013331735
Name:LISINSCHI, ADRIANA (MD)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:LISINSCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CROSSING BLVD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4154
Mailing Address - Country:US
Mailing Address - Phone:518-831-4434
Mailing Address - Fax:518-831-4435
Practice Address - Street 1:3 CROSSING BLVD
Practice Address - Street 2:SUITE ONE
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-4154
Practice Address - Country:US
Practice Address - Phone:518-831-4434
Practice Address - Fax:518-831-4435
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY275531207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04145084Medicaid
NYJ400234780Medicare PIN