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General NPI Number Information
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NPI Number | 1588535702
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Entity Type | Organization
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Legal Business Name | DR LILY MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 680 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3181
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Country | US
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Telephone | 718-757-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 442 BUCKLAND DR
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City | CHESHIRE
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State | CT
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Zip | 06410-4146
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Country | US
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Telephone | 718-757-0322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LILY SINGHAVIRANON
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Credential |
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Telephone | 718-757-0322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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