Provider Demographics
NPI:1306102199
Name:OTERO-RAMIREZ, LAUREN PATRICIA (ANP MSN)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:PATRICIA
Last Name:OTERO-RAMIREZ
Suffix:
Gender:F
Credentials:ANP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COUNTRY PL
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-5348
Mailing Address - Country:US
Mailing Address - Phone:516-697-8811
Mailing Address - Fax:
Practice Address - Street 1:4 COUNTRY PL
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-5348
Practice Address - Country:US
Practice Address - Phone:516-697-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY654618163W00000X
NYF-307762363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse