Basic Information
| Provider Information | |||||||||
| NPI: | 1356611875 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WORDEN | ||||||||
| FirstName: | LILA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 FARMINGTON AVE STE 200 | ||||||||
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| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608377500 | ||||||||
| FaxNumber: | 8608377550 | ||||||||
| Practice Location | |||||||||
| Address1: | 282 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061063322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608377500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2012 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0402X | 64994 | CT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | 2084N0402X | MD463899 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology |
No ID Information.