Provider Demographics
NPI:1710367271
Name:LAMPRINAKOS, NICOLE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:LAMPRINAKOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5737
Mailing Address - Country:US
Mailing Address - Phone:212-535-4611
Mailing Address - Fax:
Practice Address - Street 1:220 E 63RD ST
Practice Address - Street 2:LOBBY J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7660
Practice Address - Country:US
Practice Address - Phone:212-308-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-31
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019007363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant