Provider Demographics
NPI:1902441199
Name:MOLINA, LIDIA ESTHER (FNP, BC)
Entity Type:Individual
Prefix:
First Name:LIDIA
Middle Name:ESTHER
Last Name:MOLINA
Suffix:
Gender:F
Credentials:FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SPRUCE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2018
Mailing Address - Country:US
Mailing Address - Phone:786-281-6656
Mailing Address - Fax:
Practice Address - Street 1:34 SPRUCE ST FL 2
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2018
Practice Address - Country:US
Practice Address - Phone:786-281-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345163-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily