Provider Demographics
NPI:1932457074
Name:LOVELOCK, ANDREW A
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:A
Last Name:LOVELOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22039 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1915
Mailing Address - Country:US
Mailing Address - Phone:516-503-7916
Mailing Address - Fax:
Practice Address - Street 1:22039 135TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11413-1915
Practice Address - Country:US
Practice Address - Phone:516-503-7916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310099-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse