Provider Demographics
NPI:1356001796
Name:ILARIA, FILOMENA (ARNP)
Entity type:Individual
Prefix:
First Name:FILOMENA
Middle Name:
Last Name:ILARIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 ROUTE 46 W STE C110
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-2451
Mailing Address - Country:US
Mailing Address - Phone:862-505-9802
Mailing Address - Fax:888-357-4407
Practice Address - Street 1:271 ROUTE 46 W STE C110
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2451
Practice Address - Country:US
Practice Address - Phone:862-505-9802
Practice Address - Fax:888-357-4407
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01251500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily