Provider Demographics
NPI:1184352353
Name:VERNIKOV, LAUREN PAGE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAGE
Last Name:VERNIKOV
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 1:11 OCEAN CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6045
Mailing Address - Country:US
Mailing Address - Phone:718-801-1530
Mailing Address - Fax:
Practice Address - Street 1:11 OCEAN CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6045
Practice Address - Country:US
Practice Address - Phone:718-801-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist