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Individual

PROF. LIILIE FAULK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
136 ELMORA AVE, SECOND FLOOR, ELIZABETH, NJ 07202-1148
(908) 289-3400
(908) 289-4333
Mailing address
136 ELMORA AVE, SECOND FLOOR, ELIZABETH, NJ 07202-1148
(908) 289-3400
(908) 289-4333

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
212913
NC
163W00000X
Registered Nurse
Primary
26NO09751400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0109215
NJ
05
7989008
NJ
Enumeration date
01/18/2007
Last updated
07/09/2007
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