Provider Demographics
NPI:1962909556
Name:BILLAH, EMILY (NP (ADULT-GERIATRIC))
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BILLAH
Suffix:
Gender:F
Credentials:NP (ADULT-GERIATRIC)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 CINDY ST
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3059
Mailing Address - Country:US
Mailing Address - Phone:732-887-5923
Mailing Address - Fax:
Practice Address - Street 1:146 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:HOPELAWN
Practice Address - State:NJ
Practice Address - Zip Code:08861-2242
Practice Address - Country:US
Practice Address - Phone:732-697-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00814600363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty