National Provider Identifier
Kelly Anne Lisciandro, DO
Kelly Anne Lisciandro, DO is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Penfield, NY and a listed phone number of (585) 364-0025.
Profile Overview
- NPI
- 1689674814
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- July 29, 2005
- Last Updated
- October 16, 2025
Practice Location
- 481 Penbrooke Drive
- Suite 2
- Penfield, NY 14526
Phone: (585) 364-0025
Mailing Address
- 481 Penbrooke Drive Ste
- Suite 2
- Penfield, NY 14526
Specialties
- Internal Medicine Physician (207R00000X)
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1689674814
- Entity Type
- Individual
- Last Name
- Lisciandro
- First Name
- Kelly
- Middle Name
- Anne
- Name Prefix
- Dr.
- Credential
- DO
- Mailing Street Address
- 481 Penbrooke Drive Ste
- Mailing Address Line 2
- Suite 2
- Mailing City
- Penfield
- Mailing State
- NY
- Mailing ZIP Code
- 14526
- Mailing Country
- US
- Mailing Phone
- (585) 364-0025
- Mailing Fax
- (585) 364-0024
- Practice Street Address
- 481 Penbrooke Drive
- Practice Address Line 2
- Suite 2
- Practice City
- Penfield
- Practice State
- NY
- Practice ZIP Code
- 14526
- Practice Country
- US
- Practice Phone
- (585) 364-0025
- Practice Fax
- (585) 364-0024
- Enumeration Date
- July 29, 2005
- Last Updated
- October 16, 2025
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- October 16, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X), Internal Medicine Physician (207R00000X)
- Other Identifiers
- 115965BJ (NY, Preferred Care), 7441491 (NY, Aetna), 02423485 (NY), P010228369 (NY, Blue Choice)