Stacey Lee Lilligore-Green, P.T.A

Individual provider Active NPI Physical Therapy Assistant · Barrington, NJ

NPI 1285907709 · NPPES record last updated Feb 14, 2012

Key facts

NPI
1285907709
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
40QB00268700 (NJ)
Practice address
267 Lott Ave.
Barrington, NJ 08007
Phone
(609) 313-4652
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
40QB00268700NJMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00268700 NJ Yes

Addresses

Primary practice location

267 Lott Ave.
Barrington, NJ 08007

Mailing address

267 Lott Ave
Barrington, NJ 08007-1235
Phone (609) 313-4652

Other providers in Barrington, NJ

All providers in Barrington, NJ · Physical Therapy Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.