Provider Demographics
NPI:1033254446
Name:MAIGUEL, LILIANA (PT)
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:
Last Name:MAIGUEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2371 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6619
Mailing Address - Country:US
Mailing Address - Phone:718-761-1668
Mailing Address - Fax:
Practice Address - Street 1:2371 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6619
Practice Address - Country:US
Practice Address - Phone:718-761-1668
Practice Address - Fax:718-982-6751
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028445-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist