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General NPI Number Information
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NPI Number | 1487887691
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Entity Type | Individual
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Provider Name | LILY J LIM D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 345 E 24TH ST 977W
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City | NEW YORK
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State | NY
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Zip | 10010-4020
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Country | US
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Telephone | 212-998-9649
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Fax |
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Provider Business Mailing Address
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Address Line | 18641 GRAND CENTRAL PKWY
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City | JAMAICA
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State | NY
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Zip | 11432-5825
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Country | US
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Telephone | 718-264-8032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 37199
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License Number State | NY
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