MEDICARE: DR. LISANIA IRIS MILLI PHD, WHNP-BC

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	363LW0102X	Women's Health Nurse Practitioner	F420654-01	NY
2	363LW0102X	Women's Health Nurse Practitioner	26NJ00090100	NJ

General Provider Information

NPI Number	:	1851587117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISANIA IRIS MILLI PHD, WHNP-BC

Provider Business Mailing Address
First Line	:	48 BI STATE PLZ # 506
Second Line	:
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675-7003
Country	:	US
Telephone Number	:	201-903-7048
Fax Number	:	844-274-3413

Provider Business Practice Location Address
First Line	:	48 BI STATE PLZ # 506
Second Line	:
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675-7003
Country	:	US
Telephone Number	:	201-903-7048
Fax Number	:	844-274-3413

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

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	10/09/2025

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