Provider Demographics
NPI:1538466701
Name:LAWRENCE, JANINE MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:MARIE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 N NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1602
Mailing Address - Country:US
Mailing Address - Phone:917-589-4312
Mailing Address - Fax:
Practice Address - Street 1:6 EDEN ROC DR
Practice Address - Street 2:
Practice Address - City:LOCUST VALLEY
Practice Address - State:NY
Practice Address - Zip Code:11560-1117
Practice Address - Country:US
Practice Address - Phone:516-714-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6059401163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse