Healthcare Provider Details

I. General information

NPI: 1508362658
Provider Name (Legal Business Name): LILLIAN ALT MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 09/14/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 FIRST RESPONDERS WAY
HAMILTON NJ
08691-1904
US

IV. Provider business mailing address

200 HORIZON CENTER BLVD
HAMILTON NJ
08691
US

V. Phone/Fax

Practice location:
  • Phone: 973-830-9813
  • Fax:
Mailing address:
  • Phone: 973-830-9813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LILLIAN ALT
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 732-320-1888