Provider Demographics
NPI:1679822332
Name:PEREIRA, LILA (PHD)
Entity type:Individual
Prefix:DR
First Name:LILA
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LILA
Other - Middle Name:
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BOSTON CHILDRENS HEALTH PHYSICIANS
Mailing Address - Street 2:SUITE 800S
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10593
Mailing Address - Country:US
Mailing Address - Phone:914-493-7997
Mailing Address - Fax:
Practice Address - Street 1:MARIA FARERI CHILDRENS HOSPITAL
Practice Address - Street 2:100 WOODS RD
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-09
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY022617103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program