Provider Demographics
NPI:1063023356
Name:LALOR, BRITTANY ANNE (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:LALOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HILLSDALE LN
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1819
Mailing Address - Country:US
Mailing Address - Phone:631-880-8037
Mailing Address - Fax:
Practice Address - Street 1:800 COMMUNITY DR STE 206
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3821
Practice Address - Country:US
Practice Address - Phone:516-403-9104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706242163W00000X
NYF309727-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse