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General NPI Number Information
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NPI Number | 1033746805
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Entity Type | Organization
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Legal Business Name | LG NP IN FAMILY HEALTH PC
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 7217 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11234-6247
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Country | US
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Telephone | 347-863-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 7217 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11234-6247
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Country | US
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Telephone | 347-863-0777
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Fax |
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Authorized Official
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Title or Position | NP
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Name | LUSINE GRIGORYAN
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Credential | NP
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Telephone | 347-863-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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