Provider Demographics
NPI:1184404907
Name:BABILONIA, LUIS ALFREDO JR
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALFREDO
Last Name:BABILONIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WHITALL DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1149
Mailing Address - Country:US
Mailing Address - Phone:856-236-4116
Mailing Address - Fax:
Practice Address - Street 1:26 WHITALL DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1149
Practice Address - Country:US
Practice Address - Phone:856-236-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJB00147900054742343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)