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General NPI Number Information
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NPI Number | 1861545329
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Entity Type | Individual
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Provider Name | ANDREA LUMM FNP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 145 W84TH STREET MEDICAL OFFICE AT L.D.BRANDEIS HIGH SCHOOL
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 917-441-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 173 EAST 74TH STREET APT5 C
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-932-1717
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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 | F331346
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License Number State | NY
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