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General NPI Number Information
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NPI Number | 1841319258
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Entity Type | Organization
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Legal Business Name | EVELYN LLANOS MD PC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 19 SOUTHDOWN RD SUITE 16
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City | HUNTINGTON
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State | NY
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Zip | 11743-2538
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Country | US
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Telephone | 631-470-2572
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Fax | 631-385-1748
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Provider Business Mailing Address
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Address Line | 19 SOUTHDOWN RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-2538
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Country | US
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Telephone | 631-470-2572
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Fax | 631-385-1748
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVELYN LLANOS
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Credential | MD
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Telephone | 631-470-2572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2381051
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License Number State | NY
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