Provider Demographics
NPI:1417644808
Name:LONG, LOIS C (RN)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:C
Last Name:LONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LOIS
Other - Middle Name:C
Other - Last Name:SCHLUTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 DAKOTA DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:718-281-8600
Mailing Address - Fax:516-302-8657
Practice Address - Street 1:5 DAKOTA DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:718-281-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223981-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse