Healthcare Provider Details

I. General information

NPI: 1154242949
Provider Name (Legal Business Name): LAKSHMI NAIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 NORTHERN BLVD
GREAT NECK NY
11021-5207
US

IV. Provider business mailing address

611 NORTHERN BLVD
GREAT NECK NY
11021-5207
US

V. Phone/Fax

Practice location:
  • Phone: 516-325-7000
  • Fax:
Mailing address:
  • Phone: 516-325-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF433688-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: