Basic Information
| Provider Information | |||||||||
| NPI: | 1144385469 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ACKERMANN | ||||||||
| FirstName: | LILY | ||||||||
| MiddleName: | L. SOMWARU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SOMWARU | ||||||||
| OtherFirstName: | LILY | ||||||||
| OtherMiddleName: | LAMBRINI | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT STREET | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556180 | ||||||||
| FaxNumber: | 2159556410 | ||||||||
| Practice Location | |||||||||
| Address1: | 833 CHESTNUT STREET | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556180 | ||||||||
| FaxNumber: | 2159556410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 07/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD040527 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD436481 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.