Healthcare Provider Details

I. General information

NPI: 1164789145
Provider Name (Legal Business Name): LANA NIRENSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7206 NORTHERN BLVD FL 2
JACKSON HEIGHTS NY
11372-1049
US

IV. Provider business mailing address

7206 NORTHERN BLVD FL 2
JACKSON HEIGHTS NY
11372-1049
US

V. Phone/Fax

Practice location:
  • Phone: 866-670-6824
  • Fax:
Mailing address:
  • Phone: 866-670-6824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD83827
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number295730
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: