1275694713 NPI number — MRS. LYDIA ESTHER MALDONADO ESQUILIN MD

Table of content: MRS. LYDIA ESTHER MALDONADO ESQUILIN MD (NPI 1275694713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275694713 NPI number — MRS. LYDIA ESTHER MALDONADO ESQUILIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALDONADO ESQUILIN
Provider First Name:
LYDIA
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275694713
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
E26 AVE RICKY SEDA
Provider Second Line Business Mailing Address:
URB IDA MARIS GARDENS
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00727-5726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-764-8018
Provider Business Mailing Address Fax Number:
787-763-5801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WILLIAM JONES #1107 AHOS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-764-8018
Provider Business Practice Location Address Fax Number:
787-763-5801
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  10031 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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