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General NPI Number Information
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NPI Number | 1073386728
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Entity Type | Organization
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Legal Business Name | LUCILLE LORE, NP IN FAMILY HEALTH, PLLC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 2995 MIDDLE COUNTRY RD
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City | LAKE GROVE
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State | NY
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Zip | 11755-2138
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Country | US
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Telephone | 631-615-7260
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 HAWKINS AVE UNIT 335
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City | LAKE GROVE
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State | NY
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Zip | 11755-5015
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Country | US
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Telephone | 631-972-5997
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUCILLE LORE
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Credential | FNP
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Telephone | 631-972-5997
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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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