Provider Demographics
NPI:1467267450
Name:PLASENCIA, LILIBET MARIA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:LILIBET
Middle Name:MARIA
Last Name:PLASENCIA
Suffix:
Gender:
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ROUTE 17 STE 501
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2906
Mailing Address - Country:US
Mailing Address - Phone:201-457-0044
Mailing Address - Fax:
Practice Address - Street 1:100 ROOSEVELT AVE APT V10
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-3483
Practice Address - Country:US
Practice Address - Phone:848-250-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-08
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00914800363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant