Doctor Name: | MRS. LORI WEBER |
NPI Number: | 1265616452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NPRN |
License Number: | 303859 |
Business Practice Address: | 59 Southern Blvd Nesconset, NY - 117671090 |
Business Phone Number: | 6316591700 |
Business Fax Number: | 6316591743 |
Mailing Address: | 59 Southern Blvd, NESCONSET |
State: | NY |
Postal Code: | 117671090 |
Phone Number: | 6316591700 |
Fax Number: | 6316591743 |
NPI Enumeration Date: | 12/24/2007 |
NPI Last Update Date: | 03/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 303859 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |