=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407645161
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNETTE LOWE-LARKINS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2025
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 226 19TH AVE
-----------------------------------------------------
City | IRVINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07111-3715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-648-6106
-----------------------------------------------------
Fax | 914-648-6106
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 226 19TH AVE
-----------------------------------------------------
City | IRVINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07111-3715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-648-6106
-----------------------------------------------------
Fax | 914-648-6106
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number | 3118006
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------