Individual
LILLIE MANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82 TUERS AVE APT 2, JERSEY CITY, NJ 07306-3258
(610) 761-1511
Mailing address
82 TUERS AVE APT 2, JERSEY CITY, NJ 07306-3258
(610) 761-1511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
125771
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
6117
CT
Other
Enumeration date
04/29/2015
Last updated
01/03/2018
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