MEDICARE: MISS LAUREN ELENA WEISSBERG BSN, RN-BC

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	163WA2000X	Administrator Registered Nurse	746708-1	NY

General Provider Information

NPI Number	:	1750950978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LAUREN ELENA WEISSBERG BSN, RN-BC

Provider Business Mailing Address
First Line	:	2892 SHORE RD
Second Line	:
City	:	SEAFORD
State	:	NY
Zip	:	11783-3334
Country	:	US
Telephone Number	:	516-860-3274
Fax Number	:

Provider Business Practice Location Address
First Line	:	6619 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6122
Country	:	US
Telephone Number	:	347-970-9164
Fax Number	:

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

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	06/22/2021

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