person
Larisa Malisova, DO
General Practice Physician in Staten Island, New York
NPI 1861448896

Larisa Malisova is a General Practice Physician based in Brooklyn, NY. Larisa Malisova practices in Staten Island, NY and has the professional credentials of DO. The NPI Number for Larisa Malisova is 1861448896 and holds a License No. 234484 (New York).

The current practice location address for Larisa Malisova is 420 Lyndale Ave, Staten Island, NY and can be reached out via phone at 718-967-5630.

Location: 420 Lyndale Ave, Staten Island, NY, 11230-5457
person
Provider Profile Details
NPI Number
1861448896
Provider Name
Larisa Malisova
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
420 Lyndale Ave, Staten Island, NY, 11230-5457
Phone Number
718-967-5630
Fax Number
Provider Enumeration Date
05/25/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
420 Lyndale Ave
City
State
Zip
10312-6131
Phone Number
718-967-5630
Fax Number
person
Provider Business Mailing Address Details
Address
420 Lyndale Ave
City
State
Zip
10312-6131
Phone Number
718-967-5630
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
234484 (New York)
Definition
Definition to come...
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