Provider Demographics
NPI:1851491823
Name:LIMSUVANROT, LILY (DO)
Entity type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:LIMSUVANROT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 RESEARCH WAY STE 105
Mailing Address - Street 2:STONY BROOK INTERNISTS, UFPC
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6401
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2624
Practice Address - Street 1:267 E MAIN ST
Practice Address - Street 2:BUILDING C
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2874
Practice Address - Country:US
Practice Address - Phone:631-257-5290
Practice Address - Fax:631-257-5295
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY60 240391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine