Individual
LOURDES LIZ HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 E 62ND ST, NEW YORK, NY 10065-8206
(212) 752-7575
Mailing address
1268 MYRTLE AVE FL 3, BROOKLYN, NY 11221-3210
(516) 508-2588
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
817690816
NY
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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