Individual
MRS. LILLY MA-PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
180 E PULASKI RD, HUNTINGTON STATION, NY 11746-1915
(631) 425-3811
Mailing address
180 E PULASKI RD, HUNTINGTON STATION, NY 11746-1915
(631) 425-3811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
655723
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382604
NY
Other
Enumeration date
07/16/2015
Last updated
02/23/2021
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