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General NPI Number Information
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NPI Number | 1144458043
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Entity Type | Organization
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Legal Business Name | L3 AGENCY
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 116 W 23RD ST FL 5-218
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City | NEW YORK
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State | NY
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Zip | 10011-2599
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Country | US
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Telephone | 646-375-2342
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Fax |
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Provider Business Mailing Address
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Address Line | 116 W 23RD ST FL 5-218
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City | NEW YORK
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State | NY
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Zip | 10011-2599
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Country | US
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Telephone | 646-375-2342
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Fax |
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Authorized Official
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Title or Position | RN
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Name | JENIELYN LAZARO
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Credential |
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Telephone | 845-300-2740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 542303
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License Number State | NY
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