Healthcare Provider Details

I. General information

NPI: 1174749287
Provider Name (Legal Business Name): LILY HSIA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 CANAL STREET 4TH FLOOR
NEW YORK NY
10001
US

IV. Provider business mailing address

170 W 12TH ST NR 913
NEW YORK NY
10011-8202
US

V. Phone/Fax

Practice location:
  • Phone: 212-431-5501
  • Fax: 212-219-3601
Mailing address:
  • Phone: 212-604-7829
  • Fax: 212-604-2782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF000007-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: