Healthcare Provider Details

I. General information

NPI: 1023443116
Provider Name (Legal Business Name): EFRAT LAMANDRE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 STEINWAY AVE
STATEN ISLAND NY
10314-4820
US

IV. Provider business mailing address

45 BRAISTED AVE
STATEN ISLAND NY
10314-6142
US

V. Phone/Fax

Practice location:
  • Phone: 718-698-6700
  • Fax:
Mailing address:
  • Phone: 718-598-2722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00455000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: