Provider Demographics
NPI:1922006154
Name:PRIANTE, LILLIAN (CNM)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:PRIANTE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3908
Mailing Address - Country:US
Mailing Address - Phone:718-851-0811
Mailing Address - Fax:718-851-0558
Practice Address - Street 1:5211 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3908
Practice Address - Country:US
Practice Address - Phone:718-851-0811
Practice Address - Fax:718-851-0558
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001065176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02335606Medicaid
NY02335606Medicaid
NYP80560Medicare UPIN