Basic Information
Provider Information
NPI: 1447369509
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHILLER
FirstName: PATRICIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ANP, FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LILLIS
OtherFirstName: PATRICIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: ANP
OtherLastNameType: 1
Mailing Information
Address1: 235 N BELLE MEAD RD
Address2:  
City: EAST SETAUKET
State: NY
PostalCode: 117333456
CountryCode: US
TelephoneNumber: 6317513000
FaxNumber: 6316752001
Practice Location
Address1: 2500 NESCONSET HWY
Address2: SUITE 26B
City: STONY BROOK
State: NY
PostalCode: 117902555
CountryCode: US
TelephoneNumber: 6317518305
FaxNumber: 6317518318
Other Information
ProviderEnumerationDate: 08/30/2006
LastUpdateDate: 10/05/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XF301938NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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