Provider Demographics
NPI:1750325312
Name:HWEE, LILLIAN S (DO)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:S
Last Name:HWEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 FEDERAL STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1539
Mailing Address - Country:US
Mailing Address - Phone:856-541-5933
Mailing Address - Fax:856-541-3340
Practice Address - Street 1:2610 FEDERAL STREET
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-1936
Practice Address - Country:US
Practice Address - Phone:856-635-0203
Practice Address - Fax:856-225-0753
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06278500207Q00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6762808Medicaid
NJH51715Medicare UPIN
NJ052737Medicare Oscar/Certification
NJ052737ABNMedicare ID - Type Unspecified