1568753697 NPI number — MS. LIJA GIREESH FNP-BC

Table of content: MS. LIJA GIREESH FNP-BC (NPI 1568753697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568753697 NPI number — MS. LIJA GIREESH FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIREESH
Provider First Name:
LIJA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUNDERLAL
Provider Other First Name:
LIJA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568753697
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4755 OGLETOWN STANTON RD
Provider Second Line Business Mailing Address:
EMPLOYEE HEALTH, CHRISTIANA CARE HEALTH SYSTEMS
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19718-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-397-4532
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4755 OGLETOWN STANTON RD
Provider Second Line Business Practice Location Address:
EMPLOYEE HEALTH, CHRISTIANA CARE HEALTH SYSTEMS
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19718-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-397-4532
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AC000852 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: LG-0000521 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)