Provider Demographics
NPI:1144499922
Name:GILIC, VAHIDA (LPN)
Entity type:Individual
Prefix:MS
First Name:VAHIDA
Middle Name:
Last Name:GILIC
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 32ND AVE.
Mailing Address - Street 2:2N
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377
Mailing Address - Country:US
Mailing Address - Phone:347-848-0254
Mailing Address - Fax:
Practice Address - Street 1:5301 32ND AVE
Practice Address - Street 2:2N
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-1936
Practice Address - Country:US
Practice Address - Phone:347-848-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287700-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse