Provider Demographics
NPI:1659338937
Name:GEKHMAN, LILIYA (DO)
Entity Type:Individual
Prefix:
First Name:LILIYA
Middle Name:
Last Name:GEKHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 HICKORY LOOP
Mailing Address - Street 2:
Mailing Address - City:PURGITSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26852-8077
Mailing Address - Country:US
Mailing Address - Phone:315-719-1511
Mailing Address - Fax:
Practice Address - Street 1:9469 INGERSOLL DR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:NY
Practice Address - Zip Code:13156-4102
Practice Address - Country:US
Practice Address - Phone:315-719-1511
Practice Address - Fax:315-282-2847
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWBW951Medicare ID - Type Unspecified
H84273Medicare UPIN
NY66V803Medicare ID - Type Unspecified