MEDICARE: LILIANA M DE LA HOZ-AYARZA P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	019399	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083694434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIANA M DE LA HOZ-AYARZA P.T

Provider Business Mailing Address
First Line	:	9001A ROOSEVELT AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7938
Country	:	US
Telephone Number	:	718-205-4911
Fax Number	:	718-205-5946

Provider Business Practice Location Address
First Line	:	9001A ROOSEVELT AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7938
Country	:	US
Telephone Number	:	718-205-4911
Fax Number	:	718-205-5946

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	06/03/2015

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