Healthcare Provider Details

I. General information

NPI: 1780851246
Provider Name (Legal Business Name): LAUREN MELISSA DEVINS NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN MELISSA KAPLAN NPP

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

26405 LANGSTON AVE APT A
GLEN OAKS NY
11004-1042
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-5750
  • Fax:
Mailing address:
  • Phone: 917-282-2910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number401108
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number554256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: