Lisick, Daria Ann

Lisick, Daria Ann is an individual health care provider with primary practice located at 240 Riverside Dr. , Johnson City NY 13790-2732. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Lisick, Daria Ann can be contacted via phone (607) 798-9356.

Contact Information

Primary practice address
240 Riverside Dr. Johnson City NY 13790-2732
Phone: (607) 798-9356
Fax: (607) 797-1707
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 006573 New York
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 006573 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 006573-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 006573-1 New York

Profile Details

NPI number 1497832125
LBN Legal business name Lisick, Daria Ann
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Oct 26th, 2016 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1497832125 NPPES
New York MEDICAID 01793411

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