Provider Demographics
NPI:1194769976
Name:INNES, LORRAINE (MD)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:INNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-2001
Mailing Address - Country:US
Mailing Address - Phone:914-242-0725
Mailing Address - Fax:914-242-5152
Practice Address - Street 1:333 ADAMS STREET
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-2001
Practice Address - Country:US
Practice Address - Phone:914-242-0725
Practice Address - Fax:914-242-5152
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18400512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry