Healthcare Provider Details

I. General information

NPI: 1366142044
Provider Name (Legal Business Name): DANIELLE ANN LAJOUX RN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 GRAND ST
BROOKLYN NY
11211-4802
US

IV. Provider business mailing address

2530 INDEPENDENCE AVE APT 3F
BRONX NY
10463-6237
US

V. Phone/Fax

Practice location:
  • Phone: 929-299-5006
  • Fax:
Mailing address:
  • Phone: 917-520-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number646699
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF383427
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: