Provider Demographics
NPI:1972676146
Name:LAWTON-HERNANDEZ, LILLIAN (PNP)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:LAWTON-HERNANDEZ
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 BAYPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-1850
Mailing Address - Country:US
Mailing Address - Phone:631-434-1770
Mailing Address - Fax:631-434-6175
Practice Address - Street 1:3001 EXPRESSWAY DR N STE 100
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-5301
Practice Address - Country:US
Practice Address - Phone:631-434-1770
Practice Address - Fax:631-234-6175
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380495363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics