Provider Demographics
NPI:1972332906
Name:PARREIRAL, LILIANE (PTA)
Entity type:Individual
Prefix:
First Name:LILIANE
Middle Name:
Last Name:PARREIRAL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2714
Mailing Address - Country:US
Mailing Address - Phone:908-838-3674
Mailing Address - Fax:
Practice Address - Street 1:300 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2714
Practice Address - Country:US
Practice Address - Phone:908-838-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00415900225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant