Basic Information
| Provider Information | |||||||||
| NPI: | 1336510346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LILL | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSN, APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 802 TILTON RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098227979 | ||||||||
| FaxNumber: | 6098227980 | ||||||||
| Practice Location | |||||||||
| Address1: | 802 TILTON RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098227979 | ||||||||
| FaxNumber: | 6098227980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2015 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 26NJ00597600 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.