Provider Demographics
NPI:1912006982
Name:RATHI, LILLY P (MD)
Entity Type:Individual
Prefix:MRS
First Name:LILLY
Middle Name:P
Last Name:RATHI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:442 A BORDENTOWN AVENUE
Mailing Address - Street 2:LILLY P RATHI MD
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879
Mailing Address - Country:US
Mailing Address - Phone:732-727-6777
Mailing Address - Fax:732-422-4129
Practice Address - Street 1:442 A BORDENTOWN AVENUE
Practice Address - Street 2:LILLY P RATHI MD
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879
Practice Address - Country:US
Practice Address - Phone:732-727-6777
Practice Address - Fax:732-422-4129
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ04014200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1483501Medicaid
NJ1483501Medicaid
D07209Medicare UPIN