Healthcare Provider Details

I. General information

NPI: 1245660273
Provider Name (Legal Business Name): LANA O'NEILL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANA BLIDNAYA NP

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 BLAKE AVE
BROOKLYN NY
11208-3535
US

IV. Provider business mailing address

65 BROADWAY STE 1804
NEW YORK NY
10006-2560
US

V. Phone/Fax

Practice location:
  • Phone: 718-277-8303
  • Fax:
Mailing address:
  • Phone: 212-430-6677
  • Fax: 212-430-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF338297-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: