Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kelly Anne Lisciandro, DO

Individual provider Internal Medicine Physician · NPI 1689674814

Dr. Kelly Anne Lisciandro, DO is an Internal Medicine Physician in Penfield, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2005
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

481 Penbrooke Dr Ste 2
Penfield, NY 14526
Phone: (585) 364-0025
Fax: (585) 364-0024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 228369 (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 228369-1 (NY)

Record details

NPI number1689674814
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 29, 2005
Last updated in NPPESOctober 16, 2025
Certification dateOctober 16, 2025

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