Healthcare Provider Details

I. General information

NPI: 1144137886
Provider Name (Legal Business Name): MACKENZIE R LAHUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 NEW YORK RD
PLATTSBURGH NY
12903-3981
US

IV. Provider business mailing address

1542 GUIDE BOARD RD
SCHUYLER FALLS NY
12985-2210
US

V. Phone/Fax

Practice location:
  • Phone: 518-561-3803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number302087
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: