Provider Demographics
NPI:1760469530
Name:LAMBRINOS, LOIS M (NP)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:M
Last Name:LAMBRINOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:M
Other - Last Name:CUPERNALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1462 ERIE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1026
Mailing Address - Country:US
Mailing Address - Phone:518-243-1500
Mailing Address - Fax:
Practice Address - Street 1:216 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2408
Practice Address - Country:US
Practice Address - Phone:518-243-3300
Practice Address - Fax:518-377-9151
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400375363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000499473001OtherBLUE SHIELD
NY040426031915OtherFIDELIS
NY11488384OtherCAQH
NY356665OtherMVP
NYDD3847Medicare ID - Type Unspecified
NY11488384OtherCAQH