MEDICARE: CLARA LEYDA LIRIANO M.S. EDUCATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	1917315	NY

General Provider Information

NPI Number	:	1770847212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARA LEYDA LIRIANO M.S. EDUCATION

Provider Business Mailing Address
First Line	:	4314 216TH ST
Second Line	:	2ND FLOOR
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2943
Country	:	US
Telephone Number	:	718-791-9176
Fax Number	:

Provider Business Practice Location Address
First Line	:	4314 216TH ST
Second Line	:	2ND FLOOR
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2943
Country	:	US
Telephone Number	:	718-791-9176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	06/29/2012

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Directions to “ CLARA LEYDA LIRIANO M.S. EDUCATION” Practice Location

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