Provider Demographics
NPI:1447200787
Name:LILIENFELD, HARRIS C (MD, FAAP)
Entity Type:Individual
Prefix:
First Name:HARRIS
Middle Name:C
Last Name:LILIENFELD
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 FRANKLIN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2523
Mailing Address - Country:US
Mailing Address - Phone:609-896-4141
Mailing Address - Fax:609-896-3940
Practice Address - Street 1:132 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2523
Practice Address - Country:US
Practice Address - Phone:609-896-4141
Practice Address - Fax:609-896-3940
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA026989002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA02698900OtherMED. LICENSE
NJ0870005Medicaid
NJD97006Medicare UPIN