Provider Demographics
NPI:1801237029
Name:ALIEVA, LILIYA (RN)
Entity type:Individual
Prefix:
First Name:LILIYA
Middle Name:
Last Name:ALIEVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2205
Mailing Address - Country:US
Mailing Address - Phone:631-667-5320
Mailing Address - Fax:
Practice Address - Street 1:35 CHERRY CT
Practice Address - Street 2:
Practice Address - City:E NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-2205
Practice Address - Country:US
Practice Address - Phone:631-667-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY666995-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY666995-1Medicaid