National Provider Identifier Database

MARYANA LIEDKE, DO – NPI #1386987956
Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.


Contact Information

MARYANA LIEDKE, DO
1010 ROUTE 112 STE 300
PORT JEFFERSON STATION, NY11776-3386
Phone: 631-364-9119
Fax:
Website:
Specialty Taxonomy Code
* Neurology 2084N0400X

* Indicates primary specialty

NPI Profile & details for MARYANA LIEDKE

NPI Number 1386987956
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/02/2013
Last updated 12/09/2021 - About 4 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 288433
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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