National Provider Identifier
Charles J Lilly III, M.D.
Charles J Lilly III, M.D. is listed in the NPPES registry with a primary specialty of Psychiatry Physician in Penn Yan, NY and a listed phone number of (315) 531-2292.
Profile Overview
- NPI
- 1639265721
- Provider Type
- Individual
- Primary Specialty
- Psychiatry Physician
- Enumeration Date
- October 05, 2006
- Last Updated
- September 20, 2007
Practice Location
- 418 N Main St
- Penn Yan, NY 14527-1070
Phone: (315) 531-2292
Mailing Address
- 418 N Main St
- Inpatient Behavorial Health
- Penn Yan, NY 14527-1070
Specialties
- Psychiatry Physician (2084P0800X)
Full Record
- NPI
- 1639265721
- Entity Type
- Individual
- Last Name
- Lilly
- First Name
- Charles
- Middle Name
- J
- Name Suffix
- III
- Credential
- M.D.
- Mailing Street Address
- 418 N Main St
- Mailing Address Line 2
- Inpatient Behavorial Health
- Mailing City
- Penn Yan
- Mailing State
- NY
- Mailing ZIP Code
- 14527-1070
- Mailing Country
- US
- Practice Street Address
- 418 N Main St
- Practice City
- Penn Yan
- Practice State
- NY
- Practice ZIP Code
- 14527-1070
- Practice Country
- US
- Practice Phone
- (315) 531-2292
- Enumeration Date
- October 05, 2006
- Last Updated
- September 20, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatry Physician (2084P0800X)