Provider Demographics
NPI:1447587795
Name:BELAIR, LAUREN C (LPN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:BELAIR
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 1:3665 GARDENIA DR.
Mailing Address - Street 2:
Mailing Address - City:BALDINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027
Mailing Address - Country:US
Mailing Address - Phone:315-622-9576
Mailing Address - Fax:
Practice Address - Street 1:3665 GARDENIA DR.
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13207
Practice Address - Country:US
Practice Address - Phone:315-622-9576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179892-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse