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General NPI Number Information
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NPI Number | 1336305788
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Entity Type | Individual
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Provider Name | LORI NEUSHOTZ DNP, NPP, PMHCNS-BC,
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Gender | Female
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 469 FASHION AVE SUITE 732
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City | NEW YORK
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State | NY
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Zip | 10018-7605
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Country | US
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Telephone | 917-767-1958
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Fax | 212-534-3671
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Provider Business Mailing Address
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Address Line | 312 E 90TH ST APT 4D
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City | NEW YORK
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State | NY
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Zip | 10128-5195
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Country | US
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Telephone | 212-534-3671
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Fax | 212-534-3671
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 400200
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License Number State | NY
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