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General NPI Number Information
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NPI Number | 1649354119
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Entity Type | Individual
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Provider Name | LORRAINE LIRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 99 KINDERKAMACK RD STE 307
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City | WESTWOOD
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State | NJ
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Zip | 07675-3021
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Country | US
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Telephone | 201-261-6222
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Fax | 201-261-4411
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Provider Business Mailing Address
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Address Line | 680 KINDERKAMACK RD SUITE 302
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City | ORADELL
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State | NJ
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Zip | 07649-1600
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Country | US
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Telephone | 201-261-6222
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Fax | 201-261-4411
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MA71262
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License Number State | NJ
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