Provider Demographics
NPI:1922647270
Name:NUNEZ NEGRON, LILIA TERESA (MD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:TERESA
Last Name:NUNEZ NEGRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 KING AVE APT J3
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1459
Mailing Address - Country:US
Mailing Address - Phone:609-238-6433
Mailing Address - Fax:
Practice Address - Street 1:489 KING AVE APT J3
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1459
Practice Address - Country:US
Practice Address - Phone:609-238-6433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268326208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty