Individual
OLEG LISITSYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006388
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02207129
—
NY
01
—
12291667
12291667
NY
01
—
204824P
HIP
NY
01
—
2420108
UNITED HEATHCARE
NY
01
—
3693940
AETNA
NY
01
—
4C8453
HEALTH NET
NY
01
—
52917
DAVIS VISION
NY
01
—
7894651
AETNA PPO
NY
01
—
8127719
CIGNA
NY
01
—
9681151
GHI
NY
01
—
C172A1
BLUE CROSS/BLUE SHIELD
NY
01
—
P2806825
OXFORD
NY
Enumeration date
05/12/2006
Last updated
04/06/2021
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