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NPI 1902628795

NPI 1902628795 : L KANDERS NP IN ADULT HEALTH PLLC : GREAT NECK, NY

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General NPI Number Information
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    NPI Number           |    1902628795
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    Entity Type          |    Organization 
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    Legal Business Name  |    L KANDERS NP IN ADULT HEALTH PLLC 
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Dates
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    Enumeration Date     |    10/31/2024
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    Last Update Date     |    10/31/2024
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Provider Practice Location Address
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    Address Line         |    7 SOMERSET DR S 
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    City                 |    GREAT NECK
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    State                |    NY
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    Zip                  |    11020-1821
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    Country              |    US
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    Telephone            |    516-455-3630
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7 SOMERSET DR S 
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    City                 |    GREAT NECK
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    State                |    NY
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    Zip                  |    11020-1821
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    Country              |    US
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    Telephone            |    516-455-3630
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LAURAINE F KANDERS 
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    Credential           |    NP
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    Telephone            |    516-455-3630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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