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General NPI Number Information
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NPI Number | 1184159527
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Entity Type | Individual
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Provider Name | LORENA VERA
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Gender | Female
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 202 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-2119
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Country | US
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Telephone | 718-509-0630
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Fax |
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Provider Business Mailing Address
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Address Line | 88 JEFFERSON ST SUITE 301
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City | BROOKLYN
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State | NY
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Zip | 11206-6284
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Country | US
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Telephone | 718-290-6412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1073663161
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License Number State | NY
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