Provider Demographics
NPI:1306895107
Name:GUERRA, LILIA D (MD)
Entity type:Individual
Prefix:DR
First Name:LILIA
Middle Name:D
Last Name:GUERRA
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 1:150 PARK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2517
Mailing Address - Country:US
Mailing Address - Phone:978-686-0090
Mailing Address - Fax:978-682-5787
Practice Address - Street 1:150 PARK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2517
Practice Address - Country:US
Practice Address - Phone:978-686-0090
Practice Address - Fax:978-682-5787
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78233208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF71558Medicare UPIN