Provider Demographics
NPI:1427643287
Name:LILYVIC HEALTH SERVICES PC
Entity type:Organization
Organization Name:LILYVIC HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEREKE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APN-C
Authorized Official - Phone:347-407-1008
Mailing Address - Street 1:1737 WALKER AVE APT C
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4551
Mailing Address - Country:US
Mailing Address - Phone:347-407-1008
Mailing Address - Fax:
Practice Address - Street 1:1737 WALKER AVE APT C
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4551
Practice Address - Country:US
Practice Address - Phone:347-407-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty