Provider Demographics
NPI:1710941877
Name:LLANES-OBERSTEIN, ALEIDA (CNM, LM)
Entity Type:Individual
Prefix:PROF
First Name:ALEIDA
Middle Name:
Last Name:LLANES-OBERSTEIN
Suffix:
Gender:F
Credentials:CNM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11001-4107
Mailing Address - Country:US
Mailing Address - Phone:516-437-3541
Mailing Address - Fax:516-437-3542
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX 1227 SUNY DOWNSTATE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-7754
Practice Address - Fax:718-270-7634
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000137367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife