Individual
MS. MARY D LILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
(203) 937-3457
Mailing address
95 MAPLEVALE DR, WOODBRIDGE, CT 06525-1116
(203) 393-0826
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R44024
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
000513
CT
Other
Enumeration date
04/14/2006
Last updated
07/13/2011
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