Healthcare Provider Details

I. General information

NPI: 1215247226
Provider Name (Legal Business Name): LINCY ANN CHERIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N VILLAGE AVE
ROCKVILLE CENTRE NY
11570-1000
US

IV. Provider business mailing address

99 LAKESIDE DR
NEW ROCHELLE NY
10801-3132
US

V. Phone/Fax

Practice location:
  • Phone: 516-705-2873
  • Fax:
Mailing address:
  • Phone: 914-632-1761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number258779
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: