Provider Demographics
NPI:1114697109
Name:LAPOLLA, CHRISTINE (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LAPOLLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 NESCONSET HWY APT B7
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2242
Mailing Address - Country:US
Mailing Address - Phone:631-317-5633
Mailing Address - Fax:
Practice Address - Street 1:835 NESCONSET HWY APT B7
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2242
Practice Address - Country:US
Practice Address - Phone:631-317-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY821605163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse