Individual
MS. LISBETH M IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D. C.D.E.
Contact information
Practice address
501 NEW KARNER RD, STE 1A, ALBANY, NY 12205-3882
(518) 452-1337
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000147-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04134685
—
NY
01
—
166DA1
EMPIRE BLUECROSS BLUESHIELD
NY
01
—
7148118
AETNA
NY
Enumeration date
08/12/2010
Last updated
01/31/2018
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