Provider Demographics
NPI:1861868440
Name:LIPARI, JILLIAN (PT,DPT)
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:
Last Name:LIPARI
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5702
Mailing Address - Country:US
Mailing Address - Phone:908-851-0007
Mailing Address - Fax:908-851-2366
Practice Address - Street 1:2343 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5702
Practice Address - Country:US
Practice Address - Phone:908-851-0007
Practice Address - Fax:908-851-2366
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01622600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist