Lisitsyn, Oleg

Lisitsyn, Oleg is an individual health care provider with primary practice located at 731 Lydig Ave , Bronx NY 10462-2103. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lisitsyn, Oleg can be contacted via phone (718) 829-2160.

Contact Information

Primary practice address
731 Lydig Ave Bronx NY 10462-2103
Fax: (718) 829-9502
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 006388 New York

Profile Details

NPI number 1811948052
LBN Legal business name Lisitsyn, Oleg
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Apr 6th, 2021 - about 3 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 1811948052 NPPES
New York Other 7894651 AETNA PPO
New York Other 12291667 AETNA PPO
New York Other 9681151 AETNA PPO
New York MEDICAID 02207129 AETNA PPO
New York Other 3693940 AETNA PPO
New York Other 52917 AETNA PPO
New York Other P2806825 AETNA PPO
New York Other 204824P AETNA PPO
New York Other 2420108 AETNA PPO
New York Other 4C8453 AETNA PPO
New York Other 8127719 AETNA PPO
New York Other C172A1 AETNA PPO

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