Provider Demographics
NPI:1649717166
Name:SHYTI, LILJANA
Entity type:Individual
Prefix:
First Name:LILJANA
Middle Name:
Last Name:SHYTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1817 W 13TH ST
Practice Address - Street 2:2R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2433
Practice Address - Country:US
Practice Address - Phone:347-998-4812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-22
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1386636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist