Provider Demographics
NPI:1568523181
Name:PAROW, LORI A (LPN)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:PAROW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:PAROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 WALTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13607-1401
Mailing Address - Country:US
Mailing Address - Phone:315-405-6894
Mailing Address - Fax:
Practice Address - Street 1:5130 SIX CORNERS RD
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:NY
Practice Address - Zip Code:14837-9328
Practice Address - Country:US
Practice Address - Phone:607-243-7643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267183-1164X00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02411452Medicaid