Healthcare Provider Details

I. General information

NPI: 1134737059
Provider Name (Legal Business Name): LOIS LAMBRINOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 CLIFTON COUNTRY RD
CLIFTON PARK NY
12065-3878
US

IV. Provider business mailing address

56 CLIFTON COUNTRY RD
CLIFTON PARK NY
12065-3878
US

V. Phone/Fax

Practice location:
  • Phone: 518-782-3815
  • Fax: 518-782-3815
Mailing address:
  • Phone: 518-782-3815
  • Fax: 518-782-3815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LOIS LAMBRINOS
Title or Position: OWNER
Credential: MS, NPP
Phone: 518-782-3815