Provider Demographics
NPI:1730458894
Name:HAQUE, LOIS ANN (RN NCSN)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ANN
Last Name:HAQUE
Suffix:
Gender:F
Credentials:RN NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BIRCH HL
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1002
Mailing Address - Country:US
Mailing Address - Phone:516-484-0192
Mailing Address - Fax:
Practice Address - Street 1:10 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3403
Practice Address - Country:US
Practice Address - Phone:516-237-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193133-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse