Healthcare Provider Details

I. General information

NPI: 1255596094
Provider Name (Legal Business Name): LUBBNA V ALIMOHAMMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUBBNA VALLIANI MD

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 TROY SCHENECTADY RD SUITE 101
LATHAM NY
12110-2442
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD SUITE 201
LATHAM NY
12110-2442
US

V. Phone/Fax

Practice location:
  • Phone: 518-783-3110
  • Fax: 518-783-7506
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number255012
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101252290
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: