Individual
LILITHE P FELICIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCMA
Contact information
Practice address
183 S ORANGE AVE # E1409, NEWARK, NJ 07103-2757
(973) 972-5430
(973) 972-7173
Mailing address
741 S 18TH ST, NEWARK, NJ 07103-1051
(862) 214-4337
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
991372
NCCT
NJ
Enumeration date
08/18/2022
Last updated
08/18/2022
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