Provider Demographics
NPI:1568594067
Name:ROSENSTEIN, LILIA (MD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:ROSENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2481 CEDARWOOD RD
Mailing Address - Street 2:ATTN NPI
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4240
Mailing Address - Country:US
Mailing Address - Phone:440-449-5070
Mailing Address - Fax:440-720-0702
Practice Address - Street 1:2481 CEDARWOOD RD
Practice Address - Street 2:ATTN NPI
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-4240
Practice Address - Country:US
Practice Address - Phone:440-449-5070
Practice Address - Fax:440-720-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-7153-R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0550872Medicaid
OH0550872Medicaid