Provider Demographics
NPI:1780682708
Name:DELIGDISCH, LIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LIANE
Middle Name:
Last Name:DELIGDISCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:PATHOLOGY, BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-9114
Mailing Address - Fax:212-534-7491
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:PATHOLOGY, ANNENBERG 15-92
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-9114
Practice Address - Fax:212-534-7491
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY135202207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC09043Medicare UPIN
NY352071Medicare ID - Type Unspecified