Provider Demographics
NPI:1306608815
Name:LAVENDER HEALTH NP IN FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:LAVENDER HEALTH NP IN FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:646-417-4853
Mailing Address - Street 1:PO BOX 250611
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1527
Mailing Address - Country:US
Mailing Address - Phone:646-417-4853
Mailing Address - Fax:
Practice Address - Street 1:400 W 113TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1725
Practice Address - Country:US
Practice Address - Phone:646-417-4853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care