Provider Demographics
NPI:1467937169
Name:LAFARGUE, ELIZABETH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:LAFARGUE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GREENLAWN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:850-299-0763
Practice Address - Street 1:2386 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6401
Practice Address - Country:US
Practice Address - Phone:850-299-0763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily