Individual
TATYANA LISOVETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1110 ELM CIR, CAMILLUS, NY 13031-1528
(330) 361-9250
Mailing address
1110 ELM CIR, CAMILLUS, NY 13031-1528
(330) 361-9250
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
791767
NY
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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