Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA06768200 | NJ |
N | 111NI0900X | Internist | 25MA06768200 | NJ |
N | 207R00000X | Internist | D69969 | MD |
N | 111NI0900X | Internist | D69969 | MD |
N | 207RA0201X | Internist - Allergy & Immunology | 25MA06768200 | NJ |
N | 207RA0401X | Internist - Addiction Medicine | 25MA6768200 | NJ |
NPI | 1619192028 |
---|---|
Provider Name | Dr. Lillian Alt |
First Address | Pine Brook, NJ 07058-9839 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 10/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8068909 | (05) | NJ |
H12595 | (02) | NJ |