MEDICARE: LILIA B IDANAN PHYSICIAN, PC

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	207R00000X	Internal Medicine Physician	184732	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
2	184732P	OTHER	NY	HEALTHCARE PARTNERS
3	2591372	OTHER	NY	GHI
4	226AY1	OTHER	NY	EMPIRE BCBS
5	289030201	OTHER	NY	HEALTH PLUS
6	450538	OTHER	NY	AMERIHEALTH
7	0100331	OTHER	NY	AMERICHOICE
8	1112538	OTHER	NY	HEALTH FIRST
9	177179	OTHER	NY	ELDERPLAN
10	P2457769	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1548353964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LILIA B IDANAN PHYSICIAN, PC

Provider Business Mailing Address
First Line	:	153 CRESCENT DR
Second Line	:
City	:	ALBERTSON
State	:	NY
Zip	:	11507-1103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9715 64TH RD
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2250
Country	:	US
Telephone Number	:	718-275-1200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/ OWNER
Name	:	LILIA IDANAN
Credential	:	MD
Telephone Number	:	212-255-2333

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	07/16/2008

Similar Medicare Providers

1164484135 — DALIA FRUMKIN MD
Practice Location Address:

9715 64TH RD LOWR LEVEL
REGO PARK, NY
11374-2250

Practice Phone: 718-830-3333
Practice Fax: 718-830-3722

1063474930 — FRUMKIN NEPHROLOGY ASSOCIATES PC
Practice Location Address:

9715 64TH RD LOWR LEVEL
REGO PARK, NY
11374-2250

Practice Phone: 718-830-3333
Practice Fax: 718-830-3722

1073567160 — DR. GAIL NURIT FRUMKIN M.D.
Practice Location Address:

9715 64TH RD LOWR LEVEL
REGO PARK, NY
11374-2250

Practice Phone: 718-830-3333
Practice Fax: 718-830-3722

1619129962 — MS. MARCIA SEMPLE LPN
Practice Location Address:

9715 64TH RD
REGO PARK, NY
11374-2250

Practice Phone: 718-459-5592
Practice Fax:

1912150707 — SHARLENE ANTONETTE WILSON
Practice Location Address:

9715 64TH RD
REGO PARK, NY
11374-2250

Practice Phone: 718-459-5592
Practice Fax: 718-459-6047

1477706596 — MS. MONICA SHERYL THOMAS L.P.N.
Practice Location Address:

9715 64TH RD
REGO PARK, NY
11374-2250

Practice Phone: 718-459-5566
Practice Fax: 718-459-6047

Directions to “LILIA B IDANAN PHYSICIAN, PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.