Provider Demographics
NPI:1356796171
Name:LANZO-ESPINOSA, NAHYRA
Entity type:Individual
Prefix:
First Name:NAHYRA
Middle Name:
Last Name:LANZO-ESPINOSA
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 1:155 LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:CANADENSIS
Mailing Address - State:PA
Mailing Address - Zip Code:18325
Mailing Address - Country:US
Mailing Address - Phone:570-242-1001
Mailing Address - Fax:
Practice Address - Street 1:155 LAKE RD
Practice Address - Street 2:
Practice Address - City:CANADENSIS
Practice Address - State:PA
Practice Address - Zip Code:18325-7833
Practice Address - Country:US
Practice Address - Phone:570-242-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY370411-1163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant