Healthcare Provider Details

I. General information

NPI: 1669824009
Provider Name (Legal Business Name): CHRISTINA LAKOMSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST HARTFORD HOSPITAL SURGERY DEPT.
HARTFORD CT
06102-5037
US

IV. Provider business mailing address

80 SEYMOUR STREET HARTFORD HOSPITAL SURGERY DEPT.
HARTFORD CT
06102-5037
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-5022
  • Fax:
Mailing address:
  • Phone: 860-972-5022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number121836
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number006649
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number006649
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: