Provider Demographics
NPI:1518271592
Name:NNAKA, LILIAN
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:
Last Name:NNAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 LINCOLN AVE
Mailing Address - Street 2:APT 4M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4173
Mailing Address - Country:US
Mailing Address - Phone:347-240-1194
Mailing Address - Fax:
Practice Address - Street 1:765 LINCOLN AVE
Practice Address - Street 2:APT 4M
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4173
Practice Address - Country:US
Practice Address - Phone:347-240-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619959163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse