Provider Demographics
NPI:1790440295
Name:BELLINI, LILIANA (PA-C)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:BELLINI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST STE 206
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2411
Mailing Address - Country:US
Mailing Address - Phone:808-528-3888
Mailing Address - Fax:808-533-1448
Practice Address - Street 1:1329 LUSITANA ST STE 206
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2411
Practice Address - Country:US
Practice Address - Phone:808-528-3888
Practice Address - Fax:808-533-1448
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00657500363A00000X
HIAMD-1312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant