MEDICARE: SENIECE REN'A LILES-HAKIM LPN

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	164W00000X	Licensed Practical Nurse	340816-01	NY

General Provider Information

NPI Number	:	1407434749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SENIECE REN'A LILES-HAKIM LPN

Provider Business Mailing Address
First Line	:	15 OVERBROOK AVE
Second Line	:
City	:	WEST YORK
State	:	PA
Zip	:	17404-3417
Country	:	US
Telephone Number	:	516-309-6206
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 OVERBROOK AVE
Second Line	:
City	:	WEST YORK
State	:	PA
Zip	:	17404-3417
Country	:	US
Telephone Number	:	516-309-6206
Fax Number	:

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

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	03/18/2026

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