Healthcare Provider Details

I. General information

NPI: 1962434126
Provider Name (Legal Business Name): LAURA CECILIA LLINAS-LUX M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA CECILIA LLINAS M.D.

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FITCH ST STE 201
ELMIRA NY
14905-1634
US

IV. Provider business mailing address

571 SAINT JOSEPHS BLVD FL 2
ELMIRA NY
14901-3230
US

V. Phone/Fax

Practice location:
  • Phone: 607-739-4053
  • Fax: 607-739-7808
Mailing address:
  • Phone: 607-271-2050
  • Fax: 607-873-1244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number240107
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number240107
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: