Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DMITRY LISENENKOV, M.D.
ActiveDR. DMITRY LISENENKOV, M.D. is a Critical Care Medicine (Anesthesiology) healthcare provider located in STATEN ISLAND, New York. NPI 1679736953 is currently active in the NPPES registry. Verify at CMS.
Critical Care Medicine (Anesthesiology) · STATEN ISLAND, NY
Registration Details
- NPI Number
- 1679736953
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 7, 2008 (18.149386312925 yrs)
- Last Updated
- May 2, 2024
- Licenses
-
249407 (NY)25MA11111600 (NJ)
Practice Information
- Address
-
475 SEAVIEW AVECARDIOTHORACIC ICUSTATEN ISLAND, NY, 10305Browse NY providers · Browse ZIP 10305
- Phone
- 7187757770
- Primary Specialty
-
Critical Care Medicine (Anesthesiology)
207LC0200X
- Additional Specialty
- Critical Care Medicine (Anesthesiology)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.