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NPI Code Detail

MEDICARE: LILIANA ROXANA MATTHEWS

MEDICARE:   LILIANA ROXANA MATTHEWS
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
1174400000XSpecialist

General Provider Information

NPI Number : 1679307649
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILIANA ROXANA MATTHEWS
Provider Business Mailing Address
First Line : 859 47TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-2324
Country : US
Telephone Number : 201-690-8410
Fax Number :
Provider Business Practice Location Address
First Line : 859 47TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-2324
Country : US
Telephone Number : 201-690-8410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2024
Last Update Date : 08/30/2024

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Directions to “ LILIANA ROXANA MATTHEWS ” Practice Location

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