Healthcare Provider Details

I. General information

NPI: 1831653005
Provider Name (Legal Business Name): LILLEIGH STEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAIN ST
OLEAN NY
14760-1513
US

IV. Provider business mailing address

6461 MAYO RD
CATTARAUGUS NY
14719-9721
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-2600
  • Fax:
Mailing address:
  • Phone: 716-801-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number658294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: