Mary D Lilley

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

000513 Issued in CT

Practice address

950 Campbell Ave
West Haven, CT 06516-2770

Phone

(203) 932-5711

Fax

(203) 937-3457

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Mary D Lilley Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1699739979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MAPLEVALE DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251116",
            "telephone_number": "203-393-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711",
            "fax_number": "203-937-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "MARY",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "R44024",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "000513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LILLEY",
            "middle_name": "D",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jia Li, M.D., PH.D.
• Liberty Pharmacy Inc
• Joseph Anthony Licausi II
• John David Lieberman, LPC
• Edward Paul Liebmann
• Hong Ju Lin
• Shin Ru Lin, M.D.
• Lindsay T Davis MD PLLC
• Tanya Lindsay, PHARMD.
• Christina Ann Lindstrom, LCSW

• Gerontology Nurse Practitioner in West Haven, CT
• Providers in West Haven, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.