Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 144500 | NY |
N | 207VG0400X | Gynecologist | 144500 | NY |
N | 207VX0000X | Obstetrician | 144500 | NY |
NPI | 1255418786 |
---|---|
Provider Name | Lydia Valderrama-Kunion |
First Address | Westbury, NY 11590-5114 |
Second Address | Mineola, NY 11501-2530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B14223 | (02) | NY |