Provider Demographics
NPI:1932249760
Name:LIWANAG, MILAGROS CABILDO (MD)
Entity Type:Individual
Prefix:DR
First Name:MILAGROS
Middle Name:CABILDO
Last Name:LIWANAG
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 1:36 CARRIAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3118
Mailing Address - Country:US
Mailing Address - Phone:718-622-0248
Mailing Address - Fax:718-622-0248
Practice Address - Street 1:D01 EASTERN PARKWAY 1L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6120
Practice Address - Country:US
Practice Address - Phone:718-622-0248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130051208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics