MEDICARE: MRS. LOIS SCHROEDER WESTON R.N. C.P.N.P.

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	363LP0200X	Pediatric Nurse Practitioner	F380642	NY

General Provider Information

NPI Number	:	1851478630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOIS SCHROEDER WESTON R.N. C.P.N.P.

Provider Business Mailing Address
First Line	:	29-01 216TH STREET
Second Line	:	ST MARYS HOSPITAL FOR CHILDREN
City	:	BAYSIDE
State	:	NY
Zip	:	11360
Country	:	US
Telephone Number	:	718-281-8800
Fax Number	:	718-281-8994

Provider Business Practice Location Address
First Line	:	2901 216TH ST
Second Line	:	ST MARYS HOSPITAL FOR CHILDREN
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2810
Country	:	US
Telephone Number	:	718-281-8800
Fax Number	:	718-281-8994

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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