Provider Demographics
NPI:1528821881
Name:LOLAKIS, BRANDY
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:
Last Name:LOLAKIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6674 APPLEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4918
Mailing Address - Country:US
Mailing Address - Phone:330-261-6836
Mailing Address - Fax:
Practice Address - Street 1:6674 APPLEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4918
Practice Address - Country:US
Practice Address - Phone:330-261-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide