MEDICARE: MS. LIANE PAIXAO-ILLA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	26NN06526400	NJ

General Provider Information

NPI Number	:	1326212796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LIANE PAIXAO-ILLA NP

Provider Business Mailing Address
First Line	:	5 SHOREHAM CT
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-5101
Country	:	US
Telephone Number	:	609-443-6286
Fax Number	:	609-443-6286

Provider Business Practice Location Address
First Line	:	788 MOUNT PROSPECT AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-3221
Country	:	US
Telephone Number	:	973-485-6433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/16/2008

Similar Medicare Providers

1619568227 — IRONBOUND COMMUNITY HEALTH CENTER INC
Practice Location Address:

788 MOUNT PROSPECT AVE FL 2
NEWARK, NJ
07104-3221

Practice Phone: 973-433-9773
Practice Fax:

1083717482 — MT PROSPECT PHARMACEUTICAL SERVICES INC
Practice Location Address:

794 MOUNT PROSPECT AVE
NEWARK, NJ
07104-3221

Practice Phone: 973-483-4749
Practice Fax: 973-482-0643

1417167560 — MR. RICHARD A MISTICHELLI JR. RPH
Practice Location Address:

794 MOUNT PROSPECT AVE
NEWARK, NJ
07104-3221

Practice Phone: 973-483-4749
Practice Fax: 973-482-0643

1306057864 — MR. MATTHEW J PARISI JR. RPH
Practice Location Address:

794 MOUNT PROSPECT AVE
NEWARK, NJ
07104-3221

Practice Phone: 973-483-4749
Practice Fax: 973-482-0643

1083133961 — MT PROSPECT PHARMACEUTICAL SERVICES INC
Practice Location Address:

794 MOUNT PROSPECT AVE
NEWARK, NJ
07104-3221

Practice Phone: 973-483-4749
Practice Fax: 973-482-0643

1811408172 — BMG NEWARK LLC
Practice Location Address:

794 MOUNT PROSPECT AVE FL 2
NEWARK, NJ
07104-3221

Practice Phone: 973-777-0000
Practice Fax:

Directions to “ MS. LIANE PAIXAO-ILLA NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.