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General NPI Number Information
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NPI Number | 1306608815
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Entity Type | Organization
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Legal Business Name | LAVENDER HEALTH NP IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 400 W 113TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-1725
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Country | US
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Telephone | 646-417-4853
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 250611
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City | NEW YORK
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State | NY
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Zip | 10025-1527
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Country | US
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Telephone | 646-417-4853
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN BARRY
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Credential | FNP
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Telephone | 646-417-4853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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