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Individual
DR. LARISA KHISHCHENKO
Active
Individual
DR. LARISA KHISHCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
180528
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01584647
—
NY
01
—
102621BJ
PREFERRED CARE
NY
01
—
P010180528
BLUE CHOICE
NY
01
—
P050180528
BC/BS
NY
Enumeration date
07/04/2006
Last updated
05/04/2021
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