Healthcare Provider Details

I. General information

NPI: 1659296341
Provider Name (Legal Business Name): LILIANA DEL CARMEN CARMONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 COSEY BEACH AVE APT A2
EAST HAVEN CT
06512-4916
US

IV. Provider business mailing address

131 COSEY BEACH AVE APT A2
EAST HAVEN CT
06512-4916
US

V. Phone/Fax

Practice location:
  • Phone: 860-834-2126
  • Fax:
Mailing address:
  • Phone: 860-834-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number86
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: