Healthcare Provider Details

I. General information

NPI: 1982545232
Provider Name (Legal Business Name): LIYAN AFANEH M.B.B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 10/08/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NICOLLS ROAD
STONY BROOK NY
11794-8111
US

IV. Provider business mailing address

101 NICOLLS ROAD HSC T-11, ROOM 040
STONY BROOK NY
11794-8111
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2020
  • Fax:
Mailing address:
  • Phone: 631-444-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: