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General NPI Number Information
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NPI Number | 1790969996
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Entity Type | Individual
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Provider Name | LAUREN ANN AMENEDO FNP
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Gender | Female
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 113 BOWMAN AVE, PORTCHESTER MIDDLE SCHOOL
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City | PORTCHESTER
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State | NY
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Zip | 10573-2808
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Country | US
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Telephone | 914-939-1477
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Fax |
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Provider Business Mailing Address
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Address Line | 165 MAIN ST. OPEN DOOR FAMILY MEDICAL CENTER
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City | OSSINING
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State | NY
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Zip | 10562-4702
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Country | US
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Telephone | 914-941-1263
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 335225
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License Number State | NY
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