Provider Demographics
NPI:1285894857
Name:HARRIS, LORANE A (FNP)
Entity type:Individual
Prefix:
First Name:LORANE
Middle Name:A
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENN PLZ
Mailing Address - Street 2:SUITE 725
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10119-0002
Mailing Address - Country:US
Mailing Address - Phone:347-978-2081
Mailing Address - Fax:
Practice Address - Street 1:672 ST NICHOLAS AVE
Practice Address - Street 2:APT # 22
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1033
Practice Address - Country:US
Practice Address - Phone:212-690-9089
Practice Address - Fax:212-690-9089
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335480363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner