Provider Demographics
NPI:1508029968
Name:MULFORD, LORI NOREEN (RN)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:NOREEN
Last Name:MULFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43 FALLKILL RD
Mailing Address - Street 2:#16
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-3138
Mailing Address - Country:US
Mailing Address - Phone:845-635-8084
Mailing Address - Fax:845-635-8083
Practice Address - Street 1:1435 ROUTE 44
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-7832
Practice Address - Country:US
Practice Address - Phone:845-635-8084
Practice Address - Fax:845-635-8083
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320757-1163WG0000X, 163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health