Individual
MS. LILLIAN LIDUVINA VALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1111 AMSTERDAM AVENUE, ST LUKES ROOSEVELT HOSPITAL CENTER MEDICAL CLINIC, NEW YORK, NY 10025
(212) 523-4415
(212) 523-4554
Mailing address
100 WEST 105TH STREET, #D3, NEW YORK, NY 10025
(212) 523-4415
(212) 523-4554
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
2834171
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F3002971
NY
Other
Enumeration date
12/18/2006
Last updated
09/11/2025
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