Provider Demographics
NPI:1508052838
Name:HITCHCOCK, LOIS (MS, RNC,FNP/CS)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:HITCHCOCK
Suffix:
Gender:F
Credentials:MS, RNC,FNP/CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SHERWOOD HTS
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3409
Mailing Address - Country:US
Mailing Address - Phone:845-298-2728
Mailing Address - Fax:
Practice Address - Street 1:33 LIBERTY ST
Practice Address - Street 2:MEDICAL SERVICES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10045-1003
Practice Address - Country:US
Practice Address - Phone:212-720-5207
Practice Address - Fax:212-720-7775
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily