Healthcare Provider Details

I. General information

NPI: 1245161421
Provider Name (Legal Business Name): LIANA DAVYDIVNA EKMEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E 60TH ST
NEW YORK NY
10022-1939
US

IV. Provider business mailing address

113 E 60TH ST
NEW YORK NY
10022-1939
US

V. Phone/Fax

Practice location:
  • Phone: 917-456-9288
  • Fax:
Mailing address:
  • Phone: 917-456-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: