| Mrs Lisa M Distin, LPN | |
|
4849 Otisco Rd, Tully, NY 13159-3086 | |
| (315) 696-8592 | |
| Not Available |
| Full Name | Mrs Lisa M Distin |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 4849 Otisco Rd, Tully, New York |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437374642 | NPI | - | NPPES |
| 01789642 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 238458-1 (New York) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lisa M Distin, LPN 733 Middle Rd, Oswego, NY 13126-5888 Ph: (315) 343-2390 | Mrs Lisa M Distin, LPN 4849 Otisco Rd, Tully, NY 13159-3086 Ph: (315) 696-8592 |
Darcy Shirtz, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 1748 Dutch Hill Rd, Tully, NY 13159 Phone: 315-720-3171 | |
Amy Elizabeth Galletta, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 4849 Otisco Rd, Tully, NY 13159 Phone: 315-696-8592 |