Individual
KERTIS LIRIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5331 195TH ST, FRESH MEADOWS, NY 11365-1734
(917) 412-7565
Mailing address
5331 195TH ST, FRESH MEADOWS, NY 11365-1734
(917) 412-7565
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
005990-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LIRIANOPEREZ
—
NY
Enumeration date
06/16/2009
Last updated
06/16/2009
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