Individual
LILLY S LA PORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3440 MARKET ST, FLOOR 2 BEHAVIORAL HEALTH CENTER, PHILADELPHIA, PA 19104-3325
(215) 590-7296
(215) 590-7350
Mailing address
3440 MARKET ST, FLOOR 2 BEHAVIORAL HEALTH CENTER, PHILADELPHIA, PA 19104-3325
(215) 590-7296
(215) 590-7350
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MT188134
PA
Other
Enumeration date
01/03/2007
Last updated
08/17/2010
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