Organization Name: | L.C. NURSE PRACTITIONER IN ADULT HEALTH SERVICES PLLC |
NPI Number: | 1659500270 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORRAINE CALLAS (NURSE PRACTITIONER) |
Mailing Address: | 90 Hidden Pond Path Wading River |
State: | NY US |
Postal Code: | 117922175 |
Phone Number: | 6318301364 |
Fax Number: | |
NPI Enumeration Date: | 07/02/2009 |
NPI Last Update Date: | 07/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F303856 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |