Provider Demographics
NPI:1376561241
Name:LADNER, HEIDI ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:LADNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:EMERGENCY PRACTICE PLAN
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-0430
Mailing Address - Country:US
Mailing Address - Phone:610-668-6491
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS - EMERGENCY
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1231
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY232223207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6383XQMedicare ID - Type Unspecified
I14276Medicare UPIN