Provider Demographics
NPI:1720443062
Name:HAMLIN, LAQUATIA MARIE I (LPN)
Entity Type:Individual
Prefix:MS
First Name:LAQUATIA
Middle Name:MARIE
Last Name:HAMLIN
Suffix:I
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3520
Mailing Address - Country:US
Mailing Address - Phone:516-605-4052
Mailing Address - Fax:
Practice Address - Street 1:2613 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3520
Practice Address - Country:US
Practice Address - Phone:516-605-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324370-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse