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Individual
DR. KELLY ANNE LISCIANDRO
Active
Individual
DR. KELLY ANNE LISCIANDRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
228369
NY
207R00000X
Internal Medicine Physician
228369-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02423485
—
NY
01
—
115965BJ
PREFERRED CARE
NY
01
—
7441491
AETNA
NY
01
—
P010228369
BLUE CHOICE
NY
Enumeration date
07/29/2005
Last updated
10/16/2025
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