Provider Demographics
NPI:1861667016
Name:LILEIKA, INCORONATA (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:INCORONATA
Middle Name:
Last Name:LILEIKA
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:NADA
Other - Middle Name:
Other - Last Name:LILEIKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:49 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4501
Mailing Address - Country:US
Mailing Address - Phone:203-869-0177
Mailing Address - Fax:
Practice Address - Street 1:49 LAKE AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4501
Practice Address - Country:US
Practice Address - Phone:203-869-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000448231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist