Provider Demographics
NPI:1114702941
Name:BAATAI, LUWAM (LPN)
Entity Type:Individual
Prefix:
First Name:LUWAM
Middle Name:
Last Name:BAATAI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4637
Mailing Address - Country:US
Mailing Address - Phone:585-415-5738
Mailing Address - Fax:
Practice Address - Street 1:106 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-4637
Practice Address - Country:US
Practice Address - Phone:585-415-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348034164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse