Provider Demographics
NPI:1811233687
Name:LINCOLN, PRISCILLA PAGE (PSYCHIATRIC NP)
Entity Type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:PAGE
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:PSYCHIATRIC NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CAMBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1907
Mailing Address - Country:US
Mailing Address - Phone:718-857-7456
Mailing Address - Fax:
Practice Address - Street 1:11 CAMBRIDGE PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1907
Practice Address - Country:US
Practice Address - Phone:718-857-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401310-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health