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General NPI Number Information
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NPI Number | 1174513048
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Entity Type | Individual
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Provider Name | LILIANA HENRIQUEZ MD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 450 W CHEW ST SIGAL CENTER, 2ND FLOOR
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City | ALLENTOWN
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State | PA
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Zip | 18102-3434
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Country | US
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Telephone | 610-776-5160
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Fax | 610-606-4457
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Provider Business Mailing Address
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Address Line | 421 W CHEW ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3406
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Country | US
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Telephone | 610-776-5100
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Fax | 610-663-3113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD032838E
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License Number State | PA
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