Provider Demographics
NPI:1528047719
Name:VALDMAN, LYUDMILA (MD)
Entity type:Individual
Prefix:DR
First Name:LYUDMILA
Middle Name:
Last Name:VALDMAN
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 1:22 LUCILLE LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5810
Mailing Address - Country:US
Mailing Address - Phone:631-423-9883
Mailing Address - Fax:631-423-9883
Practice Address - Street 1:554 LARKFIELD RD
Practice Address - Street 2:STE 203
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4205
Practice Address - Country:US
Practice Address - Phone:631-266-6870
Practice Address - Fax:631-266-2548
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167985-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11326OtherVYTRA HEALTH PLANS
NY0000020OtherGHI
NY83D413OtherBLUE CROSS & BLUE SHIELD
NYP1677038OtherOXFORD HEALTH PLANS
NY00975764Medicaid
NY045033OtherAETNA
NY00975764Medicaid