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Organization
LILIA B IDANAN PHYSICIAN, PC
Active
Organization
LILIA B IDANAN PHYSICIAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA IDANAN MD (PRESIDENT/ OWNER)
(212) 255-2333
Entity
Organization
Contact information
Practice address
9715 64TH RD, REGO PARK, NY 11374-2250
(718) 275-1200
Mailing address
153 CRESCENT DR, ALBERTSON, NY 11507-1103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
184732
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100331
AMERICHOICE
NY
05
—
01922334
—
NY
01
—
1112538
HEALTH FIRST
NY
01
—
177179
ELDERPLAN
NY
01
—
184732P
HEALTHCARE PARTNERS
NY
01
—
226AY1
EMPIRE BCBS
NY
01
—
2591372
GHI
NY
01
—
289030201
HEALTH PLUS
NY
01
—
450538
AMERIHEALTH
NY
01
—
P2457769
OXFORD
NY
Enumeration date
09/30/2006
Last updated
07/16/2008
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