Most Relevant Information
Provider Data
| NPI Number: | 1003692971 |
| Provider Name: | LILIT VARDINA PHYSICAN ASSISTANT |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2023 |
| Last Updated: | 09/06/2023 |
Provider Practice Location
2665 HOMECREST AVE APT 3J
BROOKLYN
NY
112354533
Practice Location Phone/Fax
| Phone: | 3478413408 |
| Fax: |
Provider Mailing Location
2665 HOMECREST AVE APT 3J
BROOKLYN
NY
112354533
Provider Mailing Phone/Fax
| Phone: | 3478413408 |
| Fax: |