MEDICARE: MRS. MICKY JAYNES LAWRENCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	757926	NY
2	164W00000X	Licensed Practical Nurse	305513-1	NY

General Provider Information

NPI Number	:	1053690420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICKY JAYNES LAWRENCE

Provider Business Mailing Address
First Line	:	52 JOURNEAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2233
Country	:	US
Telephone Number	:	646-355-5075
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 JOURNEAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2233
Country	:	US
Telephone Number	:	646-355-5075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	11/01/2019

Similar Medicare Providers

1295179943 — JOHN ABRAHAM M.D.
Practice Location Address:

101 NIXON AVE , STATEN ISLAND
STATEN ISLAND, NY
10304-2233

Practice Phone: 718-744-4819
Practice Fax: 718-273-7609

1518921055 — DR. JOHN C L'INSALATA M.D.
Practice Location Address:

25 MANOR RD
STATEN ISLAND, NY
10310-2233

Practice Phone: 718-556-4700
Practice Fax: 718-556-4774

1225278179 — MS. ADRIENNE D LEE M.S.CCC/SLP
Practice Location Address:

170 GARRISON AVE
STATEN ISLAND, NY
10314-2233

Practice Phone: 917-270-2423
Practice Fax:

1982203402 — PAULINE IZZO, NURSE PRACTITIONER IN FAMILY HEALTH PC
Practice Location Address:

544 DARLINGTON AVE
STATEN ISLAND, NY
10309-2233

Practice Phone: 718-737-8717
Practice Fax:

1356603708 — MS. LAURA MARIE HAYDEN MS ED
Practice Location Address:

2233 BEDELL RD , APT 7
GRAND ISLAND, NY
14072-1660

Practice Phone: 716-297-0798
Practice Fax: 716-297-0998

1306336946 — MEGHAN KOSMAN
Practice Location Address:

2233 121ST PL
BLUE ISLAND, IL
60406-1334

Practice Phone: 708-712-4976
Practice Fax:

Directions to “ MRS. MICKY JAYNES LAWRENCE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.