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General NPI Number Information
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NPI Number | 1447418124
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Entity Type | Individual
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Provider Name | LORRAINE ATKINSON PA-C, FAAPA
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Gender | Female
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 486 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6019
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Country | US
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Telephone | 631-422-8520
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Fax | 631-422-8522
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Provider Business Mailing Address
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Address Line | 486 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6019
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Country | US
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Telephone | 631-422-8520
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Fax | 631-422-8522
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 003735-1
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License Number State | NY
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