Provider Demographics
NPI:1609988666
Name:STEEL, LILLY (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLY
Middle Name:
Last Name:STEEL
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 1:25 CRANBERRY STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901
Mailing Address - Country:US
Mailing Address - Phone:631-727-7100
Mailing Address - Fax:631-727-6754
Practice Address - Street 1:25 CRANBERRY STREET
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901
Practice Address - Country:US
Practice Address - Phone:631-727-7100
Practice Address - Fax:631-727-6754
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198916207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01777760Medicaid
NY01777760Medicaid
NY762341Medicare ID - Type Unspecified