Provider Demographics
NPI:1821022856
Name:ESTEBAN, LOURDES PINEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:PINEDA
Last Name:ESTEBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9921 4TH AVE
Mailing Address - Street 2:LL1-LL2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-8347
Mailing Address - Country:US
Mailing Address - Phone:718-748-9282
Mailing Address - Fax:718-748-4919
Practice Address - Street 1:9921 4TH AVE
Practice Address - Street 2:LL1-LL2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8347
Practice Address - Country:US
Practice Address - Phone:718-748-9282
Practice Address - Fax:718-748-4919
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY159762-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC09784Medicare UPIN