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Contact Information

DMITRY LISENENKOV, MD
475 SEAVIEW AVE
CARDIOTHORACIC ICU
STATEN ISLAND, NY10305
 Phone: 718-775-7770
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care Medicine

207LC0200X 05 Physician/Anesthesiology
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for DMITRY LISENENKOV · (Male)

NPI # 1679736953
Status Active
Credentials MD
Entity Individual
Enumeration date 07/07/2008
Last updated 05/02/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA11111600
  • NY License # 249407
Hospital affiliation(s)
  • MAIMONIDES MEDICAL CENTER - (Acute Care)
    4802 TENTH AVENUE
    BROOKLYN, NY 11219
  • MAIMONIDES MEDICAL CENTER - (Acute Care)
    4802 TENTH AVENUE
    BROOKLYN, NY 11219
  • RARITAN BAY MEDICAL CENTER - (Acute Care)
    530 NEW BRUNSWICK AVE
    PERTH AMBOY, NJ 08861
  • RARITAN BAY MEDICAL CENTER - (Acute Care)
    530 NEW BRUNSWICK AVE
    PERTH AMBOY, NJ 08861
  • SAINT CLARE'S HOSPITAL - (Acute Care)
    25 POCONO ROAD
    DENVILLE, NJ 07834
  • SAINT CLARE'S HOSPITAL - (Acute Care)
    25 POCONO ROAD
    DENVILLE, NJ 07834
  • SAINT MICHAEL'S MEDICAL CENTER INC - (Acute Care)
    111 CENTRAL AVENUE
    NEWARK, NJ 07102
  • SAINT MICHAEL'S MEDICAL CENTER INC - (Acute Care)
    111 CENTRAL AVENUE
    NEWARK, NJ 07102
  • ST MARY'S HOSPITAL PASSAIC - (Acute Care)
    350 BOULEVARD
    PASSAIC, NJ 07055
  • ST MARY'S HOSPITAL PASSAIC - (Acute Care)
    350 BOULEVARD
    PASSAIC, NJ 07055
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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