=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437220381
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN ARTHUR LILIEN D.D.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 364 FRANKLIN ST
-----------------------------------------------------
City | BLOOMFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07003-3446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-748-1515
-----------------------------------------------------
Fax | 973-748-5216
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 KATHARINA PL
-----------------------------------------------------
City | TOWNSHIP OF WASHINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07676-4125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-444-6991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | DI13298
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------