Provider Demographics
NPI:1255404406
Name:BORDEIANOU, LILIANA G (MD)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:G
Last Name:BORDEIANOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 FRESH POND LN
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4641
Mailing Address - Country:US
Mailing Address - Phone:651-312-1568
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA
Practice Address - Street 2:393 DUNLAP ST. NORTH #500
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104
Practice Address - Country:US
Practice Address - Phone:651-312-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230185208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery