Provider Demographics
NPI:1710219787
Name:ESKIN, LORIN AMANDA (PA)
Entity Type:Individual
Prefix:MISS
First Name:LORIN
Middle Name:AMANDA
Last Name:ESKIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY # CHN723
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-305-3000
Mailing Address - Fax:212-342-2996
Practice Address - Street 1:31 BANK ST
Practice Address - Street 2:APT 4W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5226
Practice Address - Country:US
Practice Address - Phone:845-304-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant