Provider Demographics
NPI:1689726556
Name:LURIE, ADELE ROSE (MS, NP-C)
Entity Type:Individual
Prefix:MS
First Name:ADELE
Middle Name:ROSE
Last Name:LURIE
Suffix:
Gender:F
Credentials:MS, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 COURTLAND DR
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6335
Mailing Address - Country:US
Mailing Address - Phone:631-328-4061
Mailing Address - Fax:631-328-4061
Practice Address - Street 1:900 FRANKLIN AVE
Practice Address - Street 2:DEPT. OF MEDICINE
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2145
Practice Address - Country:US
Practice Address - Phone:516-256-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303561363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health