Provider Demographics
NPI:1578875449
Name:THALMANN, LUCILLE KATHERINE (NP)
Entity Type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:KATHERINE
Last Name:THALMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3040
Mailing Address - Country:US
Mailing Address - Phone:631-751-1038
Mailing Address - Fax:
Practice Address - Street 1:3 VIEW RD
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3040
Practice Address - Country:US
Practice Address - Phone:631-751-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301580363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health