Provider Demographics
NPI:1205886868
Name:LIRIO, OSCAR C (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:C
Last Name:LIRIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 ERIE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1405 FULTON AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-1402
Practice Address - Country:US
Practice Address - Phone:518-243-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104401208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5980091OtherAETNA
NY3391H1OtherBLUE CROSS
NY0198343OtherGHI PPO
NY104401-5BOtherWORKERS COMP.
NY10460704OtherCAQH
NY000405348002OtherBLUE SHIELD
NY000000087256OtherGHI - HMO
NY02111OtherMVP
NY10001200 2110OtherCDPHP
NY41129000012OtherFIDELIS
NY3391H1OtherBLUE CROSS
NY41129000012OtherFIDELIS