Liedke, Maryana
Liedke, Maryana is an individual health care provider with primary practice located at 1010 Route 112 Ste 300 , Port Jefferson Station NY 11776-3386. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Liedke, Maryana can be contacted via phone (631) 364-9119.Contact Information
Primary practice address
1010 Route 112 Ste 300
Port Jefferson Station NY 11776-3386
Phone: (631) 364-9119
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 288433 | New York |
Profile Details
| NPI number | 1386987956 |
|---|---|
| LBN Legal business name | Liedke, Maryana |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 2nd, 2013 |
| Last updated | Dec 9th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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