Lisy Sam George | Queens Village, NY • PECOS Search

Lisy Sam George

Registered Nurse

Nursing Service Providers

7925 Winchester Blvd, Queens Village, NY 11427-2128

PECOS Enrollment

Based on the most recent information from CMS, provider Lisy Sam George does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1063209989
Provider Type
Individual
Full Name
George, Lisy Sam
Credential
RN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/23/2025
Last Updated
4/23/2025

Contact Information

Practice Location

7925 Winchester Blvd, Queens Village, NY 11427-2128

Unlisted Fax

Mailing Location

7925 Winchester Blvd, Queens Village, NY 11427-2128

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 968308-01 New York