Provider Demographics
NPI:1720342231
Name:YILMAZ, LISA (MS, SP ED)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:YILMAZ
Suffix:
Gender:F
Credentials:MS, SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1222
Mailing Address - Country:US
Mailing Address - Phone:516-783-0006
Mailing Address - Fax:
Practice Address - Street 1:696 WILLARD ST
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1222
Practice Address - Country:US
Practice Address - Phone:516-783-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist