Provider Demographics
NPI:1881788198
Name:BUJMAN DE LANCMAN, HAYDEE LILIANA (MD)
Entity type:Individual
Prefix:DR
First Name:HAYDEE
Middle Name:LILIANA
Last Name:BUJMAN DE LANCMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1515 SUMMER ST
Mailing Address - Street 2:STE 101
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-323-8171
Mailing Address - Fax:
Practice Address - Street 1:1515 SUMMER ST
Practice Address - Street 2:STE 101
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-323-8171
Practice Address - Fax:203-323-7122
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037157208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics