Provider Demographics
NPI:1912147760
Name:LALMIEV, DANIELLA (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:LALMIEV
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 NINTH AVENUE
Mailing Address - Street 2:FL 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:646-680-4692
Mailing Address - Fax:
Practice Address - Street 1:9610 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6625
Practice Address - Country:US
Practice Address - Phone:718-459-0400
Practice Address - Fax:718-663-5789
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013212363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant