Lydia Romanovna Kirillova, MD
Student in an Organized Health Care Education/Training Program in Phoenix, AZ. Individual provider (NPI-1).
NPI number1346861457
StatusActive
Last updated in NPPESApr 6, 2023
Details
- NPI
- 1346861457
- Entity type
- Individual (NPI-1)
- Name
- Lydia Romanovna Kirillova
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 29, 2020
- Certification date
- Apr 6, 2023
- Last updated
- Apr 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1441 N 12th St Fl 2Phoenix, AZ 85006-2837
Phone 602-521-5969 · Fax 602-521-5987
Mailing address
1441 N 12th St Fl 2Phoenix, AZ 85006-2837
Phone 602-521-5969 · Fax 602-521-5987
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