Provider Demographics
NPI:1447418124
Name:ATKINSON, LORRAINE (PA-C, FAAPA)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:PA-C, FAAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6019
Mailing Address - Country:US
Mailing Address - Phone:631-422-8520
Mailing Address - Fax:631-422-8522
Practice Address - Street 1:486 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6019
Practice Address - Country:US
Practice Address - Phone:631-422-8520
Practice Address - Fax:631-422-8522
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003735-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical