Provider Demographics
NPI:1609660703
Name:BESTA, LIZA E
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:E
Last Name:BESTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173A LAMPED LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5835
Mailing Address - Country:US
Mailing Address - Phone:718-844-9119
Mailing Address - Fax:718-844-9119
Practice Address - Street 1:173A LAMPED LOOP
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5835
Practice Address - Country:US
Practice Address - Phone:718-844-9119
Practice Address - Fax:718-844-9119
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty