Provider Demographics
NPI:1447890942
Name:SEPUT, CILA
Entity type:Individual
Prefix:
First Name:CILA
Middle Name:
Last Name:SEPUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CLARK PL APT 3
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07206-2080
Mailing Address - Country:US
Mailing Address - Phone:908-404-5692
Mailing Address - Fax:
Practice Address - Street 1:235 CLARK PL APT 3
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07206-2080
Practice Address - Country:US
Practice Address - Phone:908-404-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY775529163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse