MEDICARE: LANA BELL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency	2601595	NY

General Provider Information

NPI Number	:	1598298192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANA BELL INC.

Provider Business Mailing Address
First Line	:	1225 AVENUE R
Second Line	:	APT.4H
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1053
Country	:	US
Telephone Number	:	646-290-4561
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 AVENUE R
Second Line	:	APT.4H
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1053
Country	:	US
Telephone Number	:	646-290-4561
Fax Number	:

Authorized Official
Title or Position	:	EARLY INTERVENTION THERAPIST, SI
Name	:	RUSLANA CAMPBELL
Credential	:	MS.ED.SP.ED.
Telephone Number	:	646-290-4561

Provider Enumeration Date	:	04/10/2017
Last Update Date	:	04/10/2017

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